How to Prevent Dialysis Muscle Cramps

If you get dialysis and have muscle cramps during or after treatment, you are not alone. Muscle cramps are a common side effect of dialysis. You may feel mild tightness or strong pain that may interrupt dialysis treatment.

Learning what causes cramps, noticing early warning signs, and taking steps to prevent them may help you feel more comfortable during dialysis.

Muscle cramps during dialysis often happen because of changes in fluid or blood pressure during dialysis. Common causes include:

• Removing fluid too quickly
• A drop in blood pressure
• Changes in body salts such as sodium or potassium
• Extra fluid buildup between treatments
• Shortened or missed dialysis treatments

When fluid is removed quickly, the amount of blood in your body may drop for a short time. This can reduce blood flow to your muscles and cause cramping.

Muscle cramps often start slowly. You may notice warning signs before the pain begins such as:

• Muscle twitching
• A tight or hard feeling in a muscle
• Tender or sore muscles
• Pain starting in one area
• Sudden sharp pain, often in the legs or feet

If you notice these symptoms during dialysis, tell your care team right away.

Muscle cramps during dialysis can be uncomfortable and may make treatments harder to complete. Changes to your diet, fluid intake, and dialysis treatment (as recommended by your care team) may help reduce cramps.

Longer or more frequent dialysis treatments can help fluid be removed more slowly. This may help prevent sudden drops in blood pressure, which can cause cramps. Talk to your care team to see if more frequent treatments from the comfort of your home may be an option for you.

It’s important to complete every dialysis treatment as prescribed. Ending treatment early can lead to extra fluid building up in your body. This may require more fluid to be removed at your next treatment, which can increase the risk of cramps.

Eating too much salt can make you thirsty and cause your body to hold extra fluid. A low-sodium diet may help reduce fluid buildup and make dialysis easier on your body. Your dietitian can help you determine the best kidney-friendly foods for you.

Limiting fluid between treatments can help reduce cramping. Ways to manage your fluid include:

• Tracking how much fluid you drink each day
• Using smaller cups or bottles
• Reducing salty foods to help control thirst
• Following the fluid guidelines from your care team

Muscle cramps can sometimes happen during dialysis. If this happens, your care team can take steps to help relieve the cramps and keep you comfortable. If you get a muscle cramp:

• Tell your care team right away
• Try gentle stretching, a massage, or changing your position for relief
• Your care team may slow down fluid removal

Do not try to manage severe symptoms by yourself during treatment.

Your care team may be able to make small changes to your dialysis treatment to help reduce cramps, such as adjusting fluid removal goals, extending treatment time, or making other changes to your dialysis prescription.

You should reach out to your care team if you experience:

• Severe cramps
• Cramps that happen often
• Cramps with dizziness or fainting
• Muscle pain that lasts long after treatment

For some people, home dialysis treatments such as Peritoneal Dialysis (PD) or Home Hemodialysis (HHD) may allow gentler, more frequent dialysis treatments. Talk with your care team to learn more about what options may be available.