Vitamin E and Muscle Cramps during Dialysis

Muscle cramps can be very painful in any circumstances (I know about this the hard way). The cramp can be so painful you can hardly move. And unfortunately this can occur during hemodialysis treatment. It is not unusual for the cramp to lead to the dialysis session being terminated earlier than planned, thus leading to under-dialysis of the patient - something that should be avoided for long-term health.

Researchers at Coney Island Hospital, Brooklyn, decided to look into possible methods to prevent this painful experience, and found some reports that vitamin E may be helpful in reducing or preventing cramp during hemodialysis.

They randomly selected a small group of 19 hemodialysis patients, from different age groups and different ethnicity, where those involved had experienced at least 60 attacks of muscle cramps over a 12 week period Obviously for these patients cramps would be a major problem and any help would be appreciated. They were given daily doses of 400mg of vitamin E, and the number of attacks of cramp was recorded. The results showed that there was a 68.3% reduction in the number of attacks across the board, with no trends relating to age or gender, nor hemodialysis duration.

Their conclusion was that short-term treatment with vitamin E was a safe and effective treatment for patients suffering from cramp during and after dialysis.

Research summary

Alternatives

We checked up on other recent research into treatment for leg cramps.

Quinine has been used to treat muscle cramps, but there is some debate as to the risk-benefit ratio of this treatment. Relativley high doses are required to get a similar result in the general population to that observed for the above dialysis study. But quinine has considerable, potentially dangerous, side effects. Other hypersensitivity reactions that may occur after a single dose or after months or years of use include cinchonism, impaired vision, nausea, vomiting, epigastric pain, granulomatous hepatitis, cardiovascular effects, and hemolytic uremic syndrome. Quinine also may raise the serum level of digoxin and interact with medications used in patients with renal failure or who are on dialysis, including aluminum hydroxide, cimetidine, and heparin. Because of these potential adverse side effects, the FDA in 1995 ordered a stop to quinine marketing for the prevention or treatment of nocturnal leg cramps. And note the problems mentioned for dialysis patients.

Other treatments for cramp seem to depend on which of the wide number of possible causes of cramp that apply to the sufferer. And sadly for people like me, who sometimes suffer from nocturnal leg cramps, vitamin E was not found to be helpful in the general population, unlike in dialysis patients.

Research summary