Muscle cramps in patients with cirrhosis

To determine the prevalence of muscle cramps in subjects with chronic liver disease and to identify factors associated with their development.

We performed a cross-sectional survey in 132 subjects with chronic liver disease: cirrhotics (n = 92) and subjects with chronic hepatitis (n = 40). In addition, to control for diuretic use, patients with congestive heart failure (n = 40) were included as a comparison group.

The prevalence of chronic muscle cramps was significantly greater in cirrhotics compared with patients with chronic hepatitis [48/92 (52%) vs 3/40 (7.5%), respectively, p < 0.0001] and compared with subjects with congestive heart failure [8/40 (20%), p < 0.001]. Factors, including age, gender, alcoholic liver disease, electrolytes, and diuretic use were similar among cirrhotics with and without cramps. Significantly higher total bilirubin and lower albumin levels were noted in cirrhotics with and without cramps, respectively; however, there was no significant difference in Child's A or B classification.

There is an increased prevalence of chronic muscle cramps in subjects with cirrhosis that appears to be independent of the etiology of cirrhosis, diuretic consumption, serum electrolyte alterations, or differences in Child's classification. These results suggest that cramps in these patients are related specifically to the development of cirrhosis, and worsening liver function may be a risk factor for the development of cramps.