Abstract: FR-PO0489
Pain Associated with Skeletal Muscle Cramps in Patients on Maintenance Dialysis
Session Information
- Dialysis: Hemodiafiltration, Ultrafiltration, Profiling, and Interdialytic Symptoms
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Li, Nien Chen, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Shieu, Monica, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Harford, Antonia, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Manley, Harold, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Hsu, Caroline M., Tufts Medical Center, Boston, Massachusetts, United States
- Weiner, Daniel E., Tufts Medical Center, Boston, Massachusetts, United States
- Miskulin, Dana, Tufts Medical Center, Boston, Massachusetts, United States
- Johnson, Doug, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Lacson, Eduardo K., Dialysis Clinic Inc, Nashville, Tennessee, United States
Background
Skeletal muscle cramps are impactful for many maintenance hemodialysis (HD) patients. We hypothesized that pain contributed to self-reported bother from cramping. We explored the month-to-month change in pain that attributed to the corresponding change in bother.
Methods
We surveyed 3 items: In the past week, 1) How many cramp episodes occurred at any time, day or night (0 to >10); 2) Worst cramp pain (0-10: none to worst); and 3) Extent of being bothered by cramps (0-10: none to greatest). Dialysis staff administered questions monthly during HD from January to December 2024. We identified changes in patient-reported cramp pain and bother between consecutive monthly surveys. Cohen’s kappa coefficient was used to assess the agreement in the direction of score changes between items, classified into 3 categories: decreased, no change, and increased. Normal regression models with repeated measures (GEE) were used to quantify the score change in worst pain that was associated with a 1-point change in bother score.
Results
A total of 497 patients contributed to 3,527 monthly surveys. The mean age was 62 (±5) years; 60% were male; 38% Black, and 21% Hispanic. There were 268 (54%) patients and 690 (20%) surveys reporting at least one cramp. Those with cramps experienced 2.2 (±1.8) cramping episodes/week; the mean worst pain score was 4.5 (±2.7) and the bother score was 3.9 (±2.9). Cramping occurred ≤3x/week for 84% of patients with cramps. Among 217 pairs of monthly consecutive surveys, good agreement was observed between monthly change in pain and bother scores, with a kappa coefficient 0.63 (95% CL 0.54-0.71). A 1-point reduction in bother score was associated with a 1.2-point reduction in pain score whereas a 1-point increase in bother score was associated with a greater 1.4-point increase in pain score.
Conclusion
Over 12 months, the month-to-month change in self-reported bother from muscle cramps was significantly associated with the worst pain experienced during cramping episodes. Further study is needed to determine how other attributes of cramping (e.g. frequency, timing, location, etc.) may influence bother from skeletal muscle cramps in maintenance hemodialysis patients.