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Creatine monohydrate treatment alleviates muscle cramps associated with haemodialysis
Chiz-Tzung Chang1, Chin-Herng Wu, Chih-Wei Yang
1Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Insights
Creatine monohydrate supplementation significantly reduced the frequency of muscle cramps in patients undergoing hemodialysis (HAMC). This effect was reversible after stopping treatment, indicating creatine monohydrate is a safe option for managing HAMC.
Area of Science:
- Nephrology
- Clinical Nutrition
- Exercise Physiology
Background:
- Muscle cramps are a frequent complication of hemodialysis, with unclear underlying mechanisms.
- Disturbances in muscle energy metabolism are a potential cause of hemodialysis-associated muscle cramps (HAMC).
- Creatine monohydrate is known to enhance muscle metabolism.
Purpose of the Study:
- To investigate the clinical efficacy of creatine monohydrate in reducing HAMC.
- To assess the safety and tolerability of creatine monohydrate in this patient population.
Main Methods:
- A double-blind, placebo-controlled study involving ten patients with frequent HAMC.
- Patients received either 12 mg of creatine monohydrate or a placebo before each dialysis session for 4 weeks.
- Incidence of muscle cramps, dialysis adequacy, hemodynamics, and side effects were monitored during treatment and a subsequent 4-week washout period.
Main Results:
- Creatine monohydrate treatment led to a 60% decrease in symptomatic muscle cramps (P<0.05).
- The reduction in cramp incidence was not observed in the placebo group.
- The beneficial effect of creatine monohydrate on cramps diminished during the washout period.
- No significant changes in hematocrit, Kt/V, serum albumin, or hemodynamics were noted. Serum creatinine showed a slight increase (P<0.05).
- No adverse effects were reported in either group.
Conclusions:
- Creatine monohydrate effectively reduces the incidence of hemodialysis-associated muscle cramps.
- Creatine monohydrate appears to be a safe therapeutic agent for managing HAMC.
Background:
Muscle cramp is a common complication of haemodialysis. The exact mechanism of this complication is still unknown. Many approaches have been used to relieve the muscle cramping but have had variable effects. One of the possible mechanisms of haemodialysis-associated muscle cramps (HAMC) is the disturbance of muscle energy metabolism. Creatine monohydrate can enhance muscle metabolism. We evaluated the clinical effect of creatine monohydrate on HAMC.
Methods:
Ten patients with frequent muscle cramps during haemodialysis were randomly selected into two groups, control and placebo. In a double-blind manner, 12 mg of creatine monohydrate or placebo was given to each patient before each dialysis session for 4 weeks. The incidence of muscle cramp during haemodialysis was compared between the two groups. Dialysis adequacy, haemodynamic status, and side-effects were also evaluated. We continued to observe and compare the patients during a 4-week washout period to verify the effect of creatine monohydrate.
Results:
The frequency of symptomatic muscle cramps decreased by 60% in the creatine monohydrate treatment group (6.2+/-0.8 vs 2.6+/-1.8 times/4 weeks, P<0.05) during the treatment period. This decreasing incidence of muscle cramps disappeared in the washout period in the creatine group (6.6+/-1.1 times/4 weeks). There was no difference in the incidence of muscle cramps in the placebo group. The haematocrit, Kt/V, serum albumin, and haemodynamics remained unchanged in both groups during the treatment and washout periods. Serum creatinine increased slightly after creatine monohydrate treatment (10.7+/-3.2 vs 12.4+/-3.2 mg/dl, P<0.05). No adverse effect was found in either group during the treatment and washout periods.
Conclusion:
These data suggest that creatine monohydrate can reduce the incidence of HAMC and that it may be a safe agent.