Pharmacological Treatment for Dialysis‐Related Muscle Cramps: A Systematic Review

Abstract

ABSTRACTBackgroundPatients with end‐stage renal disease undergoing dialysis suffer from muscle cramps, a prevalent and burdensome symptom for which there is a paucity of efficient and safe treatments.AimWhat is the efficacy and safety of pharmacological interventions for the treatment of dialysis‐related muscle cramps?DesignA systematic review was conducted in OVID, CINAHL, PubMed, Web of Science, and Central Cochrane databases up to August 25, 2023.Data SourcesExperimental studies reporting on a pharmacological intervention for the treatment of dialysis‐related muscle cramps were included. The review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis, and the studies quality was assessed with the RoB2 tool.ResultsA total of 4660 studies were retrieved, and 13 articles were included. The studies reported on nine interventions: vitamin C, vitamin E, vitamin K2, vitamin B7, dextrose solutions, gabapentin, sodium chloride, creatine monohydrate, and L‐carnitine. The studies testing L‐carnitine and creatine monohydrate were the only ones deemed to have a low risk of bias. Side effects were reported in only two trials, consisting primarily of gastrointestinal discomfort and hyperglycemia. Vitamins C and E are the two most studied interventions that showed positive results in reducing the frequency, severity, and duration of dialysis‐related muscle cramps. L‐carnitine is a promising intervention that warrants further investigation.ConclusionOur review consolidates the existing evidence, elucidating the range of treatments along with their potential benefits and limitations. Future studies should uphold high‐quality standards, incorporate patient‐reported outcomes, and utilize well‐defined, robust samples to improve patient care.