Whats causing the leg cramps?

[jambo101]

Seems every night i get woken with extremely painful leg cramps, its so bad i am apprehensive about going to sleep as i know i'll be waking up in agony.
Just did a 6 day driving vacation but as the leg cramps kept me up most  nights i was in a foul mood during the day due to lack of sleep.
 Any tips/tricks or advice?

[Rerun]

You may try raising your dry weight a little.  Also, drink Tonic water.  It has quinine in it which is a natural muscle relaxer.  They are horrible!   

[Charlie B53]

Those of us on dialysis can get leg cramps if we fail to control our fluid intake so much and dialysis takes off a large amount causing cramping either during treatment and/or later while sleeping.

Many people can have leg cramps from over-use, or if their potassium levels become too low.

Kidney patients need regular blood tests to know their potassium levels as potassium is difficult for damaged kidneys to clear from the blood.  So while eating more potassium may be perfectly fine for a 'normal' person, it may not be such a good idea for a renal patient.

Another possibility is dehydration.  To low on water can cause cramping.  Pinch and hold the skin on the back of your hand.  Release and watch closely to see how long it takes to fall back flat and normal.  If it takes more than a second or two then it is possible that you are beginning to dehydrate a little.  While plain water is good you need that little bit of minerals so something like Gatoraid or any of those sports drinks can be helpful in speeding rehydration.  Just don't over-do it.

Dr chewed my butt once he found out I drove as far as I did.  They highly recommend we take a break and walk about at least every two hours, preferably every hour.

Hope I've helped.

Take Care,

Charlie B53

[Marilee]

Hi Jambo -

My hubby was getting leg cramps at night so often just before beginning life on dialysis, and it persisted for about a year until A) They increased the number of cycles that he does (he's on PD) and B) We got his electrolytes in better balance. In the meantime, things that helped get through that really horrid period included: A homeopathic remedy called Hyland's Leg Cramp http://www.hylands.com/products/hylands-leg-cramps
and stretching the muscle out. Both are hard to remember to do when the darn things wake you up so abruptly, though.
Part of getting his electrolytes in balance included drinking enough water and taking potassium tablets (because some of his meds to lower blood pressure cause his potassium levels to be low). Cramps can be so frustrating because muscles will cramp from too much AND/OR too little of the cocktail of electrolytes (e.g. too much potassium as well as too little potassium), so it can be tough to know without checking blood work and reading the fine print on all your meds to see if they are messing with 'em.

I'm sorry you're having to deal with all this pain.

[jambo101]

 I was under the impression potassium was something i needed to avoid, i will start drink some diet tonic water. makes me wonder what happens when you are in the dialysis chair and a bout of leg cramps happes

[cassandra]

Ask for sodium bicarb capsules. Might preserve some renul function too.


Good luck, Cas

[rcjordan]

Like Marillee's husband, I was having multiple bouts of severe leg cramps every night years before my kidneys failed.  I had a standing prescription for quinine which I used until the US declared it for malaria-only raised the price from $15/bottle to $300.  I tried Hyland's --didn't work for me.  I eventually settled on a daily potassium booster of 200mg along with a weekly calcium and magnesium capsule. That worked pretty well, enough so that I could get some sleep most nights. 

Then I went on dialysis and the nocturnal leg cramps returned.  I'm now on home hemo and they've gotten worse. So much so that sleep deprivation in a major issue.  My nephr is working with me on the problem now.

> potassium was something i needed to avoid

That's my thinking as well, so my diet was fairly strict. My potassium was trending downward.  My doc had first suggested taking a calcium supplement when the cramps hit. Now that the situation isn't resolved, he's increasing the potassium in my dialysate.  We'll see what happens. I may need to push the upper limits.

Note that taking a dose of yellow mustard when a cramp hits helps some for lesser cramps. My nurse says it's the vinegar in the mustard. I'll explore that, too.

[Marilee]

I found a link at WebMD that lists the drugs that can be involved in leg cramps: https://www.webmd.com/pain-management/muscle-spasms-cramps-charley-horse#1 that might help.

My hubby's got two of them (Lovastatin and Furosemide) in his daily meds - and used to have Hydrochlorothiazide (HDTZ) but they said that it isn't effective when kidneys fail, so they took him off that some time ago and added Furosemide this year.

The cramps only recently resolved for him, and we change SOMETHING at every monthly doctor's visit (I.e., diet, meds, dialysis prescription) so I really can't point at the specific change responsible for his improvement.

For example, he had also been on Benazepril until January this year (had been on it for several years) and it seems like a few months after going off it his muscle cramps quit. But the literature for Benazepril actually warns that it can cause elevated potassium levels, while the Lovastatin and Furosemide can lower potassium levels. I don't know what kind of interactions were going on there... I just know that his cramps got better.

[rcjordan]

>Lovastatin and Furosemide

Thanks for that. If I can't strike a balance with diet, calcium, and -perhaps- magnesium supplements, I'll ask the doc to try those.  I'll have to do something to reign in these 'tendon-rippers.'

[Marilee]

I didn't write that very well: Lovastatin and Furosamide can CAUSE cramping because they shed potassium too much/too quickly. They're the reason my hubby takes potassium supplements.

Another change that was going on at the same time this year had to do with him being anemic (not making enough red blood cells): They started him on Erythropoietin shots and stopped his taking OTC Vitamin D3. His anemia has been improving at the same time his cramps have been diminishing. Maybe just a coincidence, maybe his body is actually USING the minerals better now that he can make blood cells... This is why it's so hard to nail down: It's all so interconnected.

[iolaire]

>Lovastatin and Furosemide

Thanks for that. If I can't strike a balance with diet, calcium, and -perhaps- magnesium supplements, I'll ask the doc to try those.  I'll have to do something to reign in these 'tendon-rippers.'

Make sure you are making these choices based on lab work that shows if some mineral is too low or too high.

[jambo101]

 I do take large doses of the diuretic Furosimide 140 in the am another 140 in the pm.

[Marilee]

Furosamide: Just to compare, my hubby takes 40mg twice a day - for mild edema.

You might want to double-check your dosage with your doctor and be sure to tell him all your uncomfortable symptoms because Itching and Tinnitus are known side-effects from too much of this drug. See this page for details: https://www.rxlist.com/lasix-drug/patient-images-side-effects.htm


Here's an abbreviated quote:
"Stop using furosemide and call your doctor at once if you have a serious side effect such as:
ringing in your ears, hearing loss;
itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
severe pain in your upper stomach spreading to your back, nausea and vomiting;
weight loss, body aches, numbness;
swelling, rapid weight gain, urinating less than usual or not at all;
chest pain, new or worsening cough with fever, trouble breathing;
pale skin, bruising, unusual bleeding, feeling light-headed, rapid heart rate, trouble concentrating;
low potassium (confusion, uneven heart rate, leg discomfort, muscle weakness or limp feeling);
low calcium (tingly feeling around your mouth, muscle tightness or contraction, overactive reflexes);
headache, feeling unsteady, weak or shallow breathing; or
severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling."