*2.2.1 Muscle cramps*

Muscle cramps are a common cause of intradialytic discomfort and a frequent complication with an incidence of 5–20% in haemodialysis sessions [6].

It frequently involves the leg and leads to premature termination of haemodialysis. Pathogenesis is unknown and largely attributed to dialysis-induced volume

contraction and hypo-osmolality.

Management strategy includes increasing plasma osmolality by infusion of hypertonic saline (15 ml of 23.5%), or 50% dextrose in water (25–50 ml), or mannitol 25% (50 ml) [6, 7]. Evaluating for other causes of muscle cramps like thyroid disorder and electrolyte disturbances.

Prevention includes dietary counselling about excessive weight gain.

Beneficial effects of quinine sulphate (250–300 mg) or oxazepam (5 mg) given two hours prior to dialysis have been seen in some studies.

In some of the studies, vitamins E, L-carnitine, and enalapril have been used with some success [7].
