Creatine monohydrate treatment alleviates muscle cramps associated with haemodialysis

Background. Muscle cramp is a common complication of haemodialysis. The exact mechanism of this complication is still unknown. Many approaches have been used to relieve the muscle cramping but have had variable effects. One of the possible mechanisms of haemodialysis-associated muscle cramps (HAMC) is the disturbance of muscle energy metabolism. Creatine monohydrate can enhance muscle metabolism. We evaluated the clinical effect of creatine monohydrate on HAMC. Methods. Ten patients with frequent muscle cramps during haemodialysis were randomly selected into two groups, control and placebo. In a double-blind manner, 12 mg of creatine monohydrate or placebo was given to each patient before each dialysis session for 4 weeks. The incidence of muscle cramp during haemodialysis was compared between the two groups. Dialysis adequacy, haemodynamic status, and side-effects were also evaluated. We continued to observe and compare the patients during a 4-week washout period to verify the effect of creatine monohydrate. Results. The frequency of symptomatic muscle cramps decreased by 60% in the creatine monohydrate treatment group (6.2 ± 0.8 vs 2.6 ± 1.8 times/4 weeks, P