title: Dialysis leg cramps. Efficacy of quinine versus vitamin E.
abstract: A controlled randomized double-blind study was done to determine the frequency and severity of leg cramps in 40 patients on dialysis with a history of leg cramps. All patients entered a 2 month placebo washout and were randomized into a 2 month double-dummy phase of quinine 325 mg at bedtime versus vitamin E 400 IU at bedtime. Of the 29 patients completing the study, 16 received quinine and 13 vitamin E. During placebo washout, the vitamin E group had a mean of 10.4 leg cramps per month, and the quinine group had a mean of 10.9. The vitamin E and quinine groups had a 1 month reduction in leg cramps to 3.3 and 3.6, respectively (p < 0.0005 for both groups combined); this was sustained at 2 months. A severity of pain index showed a statistically significant decrease for both groups. The 95% confidence interval for the difference between the number of leg cramps after vitamin E versus quinine treatment (95% confidence interval, -3.8, +3.2) suggests similar efficacy. Quinine and vitamin E were effective treatments for leg cramps in these patients. Considering the potential toxicity of quinine, vitamin E is recommended as the initial treatment of choice for patients on dialysis with leg cramps.
authors.affiliation: Department of Internal Medicine, Northeastern Ohio Universities College of Medicine, Rootstown.
authors.forename: A O
authors.initials: AO
authors.lastname: Roca
authors.forename: D
authors.initials: D
authors.lastname: Jarjoura
authors.forename: D
authors.initials: D
authors.lastname: Blend
authors.forename: A
authors.initials: A
authors.lastname: Cugino
authors.forename: G W
authors.initials: GW
authors.lastname: Rutecki
authors.forename: P S
authors.initials: PS
authors.lastname: Nuchikat
authors.forename: F C
authors.initials: FC
authors.lastname: Whittier
mesh_terms: D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D009120:Muscle Cramp / Q000188:drug therapy* / Q000209:etiology; D011803:Quinine / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000009:adverse effects*; D014810:Vitamin E / Q000627:therapeutic use*
chemical_list: D014810:Vitamin E; D011803:Quinine