Muscle Cramps in Liver Cirrhosis : Clinical Features and Related Factors

Cho, Jae Hyun; Choi, Jeong Il; Geum, Min Su; Tak, Won Young; Kweon, Young Oh; Kim, Sung Kook; Choi, Yong Hwan; Chung, Joon Mo

Abstract

BACKGROUND/AIMS: Muscle cramps are observed frequently in the course of liver cirrhosis. We studied the prevalance and clinical features and associated factors of muscle cramps in cirrhotic patients.
METHODS
We performed a cross-sectional survey for 65 cirrhotic patients with a standardized questionnaire and laboratory tests.
RESULTS
The prevalence of muscle cramps in the patients with cirrhosis was 46% (30/65). Muscle cramps occurred frequently during sleep (60%) and involved calves (70.0%), hands (63.3%), thighs (43.3%) and feet (33.3%). There were no significant differences in sex, age, etiology of cirrhosis, alcohol intake and diuretics use between cirrhotic patients with and without cramps. However, the group with cramps have more tense ascites, lower serum albumin level, higher serum total bilirubin level and higher Child's score. They also have higher blood pH level, lower mean arterial pressure, lower serum sodium level and lower total calcium level. However, ionized calcium level was similar in both group.
CONCLUSIONS
The prevalence of muscle cramps in cirrhotic patients is 46%. Muscle cramps in cirrhotic patients may not be related to diuretics or alcohol intake. The deranged metabolism due to impairment of hepatic function and decreased effective plasma volume can be related to muscle cramps multifactorially.