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• W4212882550 abstract "Muscle cramps are a frequent intradialytic complication in hemodialysis (HD). Excessive ultrafiltration, intradialytic hypotension and hypoosmolality are the most frequent causes. But, what if severe acidosis in hemodialysis patients was incriminated too? The aim of this study is to investigate cramps in patients with severe acidosis and the evolution after acidosis treatment. It was a prospective study in the hemodialysis unit of Sfax CNSS policlinic, TUNISIA, during January 2021. We colligated all patients suffering from cramps and presenting a blood bicarbonate (HCO3-) inferior to 13mmol/L. We performed a questionnaire in order to study cramps characteristics from patients perception(image 1). The severity of the cramps was scored on a 1–10 scale. The rating of 1 reflected the least severity and 10 reflected the maximal severity. The clinical data and laboratory results of the patients were obtained from the center database. After acidosis treatment with bicarbonate supplementation, we asked patients again the same questionnaire to judge the evolution. Over the 44 patients of the unit, there were 6 patients with severe acidosis and muscle cramps (13,63%) . The mean age was 55 years. Hemodialysis was carried on for an average of 14,5 years [8-33 years], with high flux membranes. Demographic and medical data are summarized in table 1. Only two patients out of 6 presented intradialytic hypotension. The mean interdialytic weight gain, intradialytic ultrafiltration (UF) and electrolytes levels are summarized in table 2. The initial blood HCO3- mean level was 9,25mmol/l [7,7-13mmol/l], with no lactic acidosis. The six patients reported having muscles cramps with a frequency of 3 days a week within the previous 3 months. The cramp severity score was initially at a mean of 7. Muscles cramps occurred on hemodialysis days and lasted for few minutes for all patients. It developed essentially in the leg muscles. Four patients requested that fluid removal be decreased and hypertonic saline be administrated as a solution to stop the muscle cramps during the session. Three of them eat salty foods during and after sessions to prevent cramps occurence. Patients received 150 ml of IV sodium bicarbonate 14% over 2 hours of hemodialysis for 3 consecutive hemodialysis sessions. blood HCO3- mean level increased to 13,4mmol/l[12,6-19,6mmol/l]. After treatment, four patients reported total disappearance of muscles cramps. The remaining 2 patients reported a decrease in the frequency (2days a week on hemodialysis day), a decrease in severity score from 7 to respectively 5 and 3 and a decrease in duration. This study suggest that frequency and severity of muscle cramps both decrease when blood HCO3- levels increase, especially for patients with severe acidosis. Further studies are needed to determine the link between metabolic acidosis and muscles cramps and to evaluate the efficacy and safety of bicarbonate treatment in HD patients with cramps." @default.
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• W4212882550 date "2022-02-01" @default.
• W4212882550 modified "2023-09-26" @default.
• W4212882550 title "POS-633 SEVERE ACIDOSIS AND RELATIONSHIP WITH MUSCLE CRAMPS IN HEMODIALYSIS PATIENTS: A SINGLE-CENTER STUDY" @default.
• W4212882550 doi "https://doi.org/10.1016/j.ekir.2022.01.666" @default.
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