Biotin Ameliorates Muscle Cramps of Hemodialysis Patients: A Prospective Trial

Abstract

Patients with renal failure undergoing hemodialysis often have muscle cramps during and after the dialysis therapy. Muscle cramps are defined as the sudden onset of a prolonged involuntary muscle contraction accompanied with severe pain, resulting in early termination of a HD session and inadequate dialysis. The etiology of the cramps is unknown and effective anti-cramp medicine is not available. We have hypothesized that water-soluble vitamins are deficient in HD patients. Accordingly, we administrated biotin to 14 patients who had frequent muscle cramps during HD sessions. Oral administration of 1 mg/day biotin promptly reduced the onset and the severity of cramps in 12 patients both during and after HD. Then, the plasma biotin levels were measured by an enzyme-linked immunosorbent assay method (ELISA) in HD patients, including 14 patients with cramps and 13 patients without cramps, and 11 healthy volunteers. Plasma biotin levels were elevated in 27 HD patients at baseline compared with healthy volunteers [451 (377 -649) vs. 224 (148 -308) ng/l, median (lower-upper quartiles); p < 0.0001]. Unexpectedly, among the 14 cramp patients, the biotin levels were significantly higher in biotin-ineffective 7 patients than biotin-effective 7 patients [1,064 (710 -1,187) vs. 445 (359 -476) ng/l; p < 0.001]. Thus, the biotins measured by ELISA may consist of not only intact biotin but also its metabolites that do not function as a vitamin. In conclusion, biotin administration is one choice to relieve HD patients from muscle cramps regardless of their elevated plasma biotin levels.

Effect of Reflexology Foot Massage on Leg Cramps for Patients on Hemodialysis.

“…It was developed by the researcher after review of relevant literature (19,(20)(21)(22) and it consisted of two parts: Part (I): it included the following items related to leg cramps: 1. Site (right leg, left leg or both legs) 2.…”

“…Leg cramps are defined as the sudden onset, painful and prolonged involuntary muscle contraction that may be visible or palpable (1,2) . Despite the "benign" nature of cramps, many patients find the symptom very uncomfortable (3).…”

Plasma Levels of Biotin Metabolites Are Elevated in Hemodialysis Patients with Cramps

“…Scores were measured before and after oral biotin administration as reported previously (Oguma et al 2012). Twentyeight HD patients (12 patients without cramps and 16 patients with cramps) and 11 healthy volunteers were studied.…”

“…In our previous study (Oguma et al 2012), oral biotin was administered to patients with frequent muscle cramps during HD sessions. The administered biotin promptly reduced the incidence and severity of cramps in most patients.…”

Is Routine Multivitamin Supplementation Necessary in US Chronic Adult Hemodialysis Patients? A Systematic Review

“…In a study by Oguma et al, 27 Japanese HD patients found that biotin levels were significantly higher than controls, but the assay used may have been measuring biotin and its metabolites 40 .…”