title: Prevention of hemodialysis-related muscle cramps by intradialytic use of sequential compression devices: a report of four cases.
abstract: BACKGROUND
  Hemodialysis (HD)-related lower extremity (LE) muscle cramps are a common cause of morbidity in end-stage renal disease patients on maintenance HD. Numerous pharmacologic and physical measures have been tried with variable success rates.
  
  
  METHODS
  Sequential compression devices (SCD) improve venous return (VR) and are commonly used to prevent LE deep venous thrombosis in hospitals. We hypothesized that LE cramps are triggered by stagnant venous flow during HD and are preventable by improving VR. We prospectively studied four adult patients (mean age 61 +/- 14 years) on thrice-weekly HD who experienced two or more episodes of LE cramping weekly in the month before the study. SCD were applied before each HD on both legs and compressions were intermittently applied at 40 mmHg during treatment.
  
  
  RESULTS
  All four patients reported complete resolution of cramping during the study period that lasted 1 month or 12 consecutive dialysis treatments.
  
  
  CONCLUSIONS
  Application of SCD to LE may prevent the generation of LE HD-related cramping in a select group of patients. Larger, controlled studies are needed to establish the utility of this noninvasive alternative for the prevention of LE HD-related cramps.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Henry Ford Health System, Detroit, Michigan, U.S.A. MANephro@yahoo.com
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ahsan
authors.forename: Mini
authors.initials: M
authors.lastname: Gupta
authors.forename: Irfan
authors.initials: I
authors.lastname: Omar
authors.forename: Stanley
authors.initials: S
authors.lastname: Frinak
authors.forename: Suzette
authors.initials: S
authors.lastname: Gendjar
authors.forename: Yayha
authors.initials: Y
authors.lastname: Osman-Malik
authors.forename: Jerry
authors.initials: J
authors.lastname: Yee