Prevention of hemodialysis‐related muscle cramps by intradialytic use of sequential compression devices: A report of four cases

Ahsan, Muhammad; Gupta, Mini; Irfan, Omar; Frinak, Stanley; Gendjar, Suzette; Osman-Malik, Yayha; Yee, Jerry

doi:10.1111/j.1492-7535.2004.01106.x

Cited by 18 publications

(28 citation statements)

References 11 publications

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“…The first description was dated from 1974 when this device was used to optimize ultrafiltration in edematous patients on HD [12]. In 2004, its ability to prevent intradialytic muscle cramps was demonstrated [13]. The first attempt to use pneumatic compression to prevent hypotension was initially reported in 3 patients on dialysis [14].…”

Section: Discussionmentioning

confidence: 99%

Pneumatic Compression, But Not Exercise, Can Avoid Intradialytic Hypotension: A Randomized Trial

et al. 2017

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Background: Conventional hemodialysis (HD) is associated with dialysis-induced hypotension (DIH) and ineffective phosphate removal. As the main source of extracellular fluid removed during HD are the legs, we sought to reduce DIH and increase phosphate removal by using cycling and pneumatic compression, which would potentially provide higher venous return, preserving central blood flow and also offering more phosphate to the dialyzer. Methods: We evaluated 21 patients in a randomized crossover fashion in which each patient underwent 3 different HD: control; cycling exercise during the first 60 min; and pneumatic compression during the first 60 min. Data obtained included bioelectrical impedance, hourly blood pressure measurement, biochemical parameters, and direct quantification of phosphate through the dialysate. DIH was defined as a drop in mean arterial pressure (MAP) ≥20 mm Hg. Results: There was no difference in the ultrafiltration rate (p = 0.628), delta weight (p = 0.415), delta of total, intra and extracellular body water among the control, cycling, and pneumatic compression (p = 0.209, p = 0.348, and p = 0.467 respectively). Delta MAP was less changed by pneumatic compression when compared to control, cycling, and pneumatic compression respectively (-4.7 [-17.2, 8.2], -4.7 [-20.5, -0.2], and -2.3 [-8.1, 9.0] mm Hg; p = 0.021). DIH occurred in 43, 38, and 24% of patients in control, cycling, and pneumatic compression respectively (p = 0.014). Phosphate removal did not increase in any intervention (p = 0.486). Higher phosphate removal was dependent on ultrafiltration, pre dialysis serum phosphate, and higher parathyroid hormone. Conclusion: Pneumatic compression during the first hour of dialysis was associated with less DIH, albeit there was no effect on fluid parameters. Neither exercise nor pneumatic compression increased phosphate removal.

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Section: Discussionmentioning

confidence: 99%

Pneumatic Compression, But Not Exercise, Can Avoid Intradialytic Hypotension: A Randomized Trial

et al. 2017

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“…Today, the intradialytic cramp rate fell down to 2% in a week owing to the improvements in the dialysis technology (Ahsan et al, 2004). Although cramps are mostly seen in the lower extremities, they can also occur in the abdomen, arms and hands.…”

Section: Crampsmentioning

confidence: 99%

“…Subnormal muscle metabolism is considered as the most important factor in cramp etiology (Chang et al, 2002). For this reason, hypotension, changes in plasma osmolarity, hyponatremia, carnitine deficiency, hypomagnesemia and tissue hypoxia are thought to cause development of cramps (Ahsan et al, 2004;Chou et al, 1985;Khajehdehi et al, 2001). In these aforesaid situations, the muscle metabolism is impaired and cramps develop.…”

Section: Crampsmentioning

confidence: 99%

Acute Complications of Hemodialysis

Özkan¹,

Ulusoy²

2011

Technical Problems in Patients on Hemodialysis

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“…However, an uncontrolled study of four hemodialysis patients with frequent muscle cramps found that applying a mechanical compression device to the legs reduced the frequency of cramps. (10) A study with 80 participants utilizing reflexology to decrease fatigue, pain, and cramps in hemodialysis patients showed promising results. (13) While promising, our findings must be considered preliminary because of several limitations.…”

Section: Resultsmentioning

confidence: 99%

“…(8,9) Therapeutic maneuvers to manage muscle cramps include intravenous fluids, oral medications, adjustments in dialysis settings, warm moisture compresses, and stretching. (8,9) One pilot study by Ahsan et al (10) evaluated the feasibility of intradialytic sequential compression devices (SCD) use for the prevention of hemodialysis-related lower extremity cramping. This study found that the application of SCD to lower extremities prevented the generation of hemodialysis related cramping in four cases.…”

mentioning

confidence: 99%

Intradialytic Massage for Leg Cramps Among Hemodialysis Patients: a Pilot Randomized Controlled Trial

Mastnardo

Lewis

Hall

et al. 2016

IJTMB

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Background: Patients on hemodialysis often experience muscle cramps that result in discomfort, shortened treatment times, and inadequate dialysis dose. Cramps have been associated with adversely affecting sleep and health-related quality of life, depression and anxiety. There is limited evidence available about massage in dialysis; however, massage in cancer patients has demonstrated decreases in pain, inflammation, and feelings of anxiety. These correlations indicate massage may be an effective treatment modality for hemodialysis-related lower extremity cramping.Purpose: To determine the effectiveness of intradialytic massage on the frequency of cramping among hemodialysis patients prone to lower extremity cramping.Participants: 26 maintenance hemodialysis patients with frequent lower extremity cramps.Setting: three outpatient hemodialysis centers in Northeast Ohio.Research Design: randomized controlled trial. Intervention: The intervention group received a 20-minute massage of the lower extremities during each treatment (three times per week) for two weeks. The control group received usual care by dialysis center staff.Main Outcome Measure: change in frequency of lower leg cramping.Results: Patient reported cramping at home decreased by 1.3 episodes per week in the intervention group compared to 0.2 episodes per week in the control group (p=.005). Patient reported cramping during dialysis decreased by 0.8 episodes in the intervention group compared to 0.4 episodes in the control group (p=0.44).Conclusion: Intradialytic massage appears to be an effective way to address muscle cramping. Larger studies with longer duration should be conducted to further examine this approach.

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Prevention of hemodialysis‐related muscle cramps by intradialytic use of sequential compression devices: A report of four cases

Abstract: Application of SCD to LE may prevent the generation of LE HD-related cramping in a select group of patients. Larger, controlled studies are needed to establish the utility of this noninvasive alternative for the prevention of LE HD-related cramps.

Cited by 18 publications

References 11 publications

Pneumatic Compression, But Not Exercise, Can Avoid Intradialytic Hypotension: A Randomized Trial

Pneumatic Compression, But Not Exercise, Can Avoid Intradialytic Hypotension: A Randomized Trial

Acute Complications of Hemodialysis

Intradialytic Massage for Leg Cramps Among Hemodialysis Patients: a Pilot Randomized Controlled Trial

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