{"id":5792,"date":"2023-08-24T19:49:46","date_gmt":"2023-08-25T00:49:46","guid":{"rendered":"https:\/\/ami.advancedrenaleducation.com\/wparep\/?post_type=article&p=5792"},"modified":"2025-05-09T11:15:03","modified_gmt":"2025-05-09T16:15:03","slug":"calambres-sp","status":"publish","type":"article","link":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/","title":{"rendered":"Calambres"},"content":{"rendered":"
\n

Etiolog\u00eda<\/strong><\/h4>\n
    \n
  • Aproximadamente el 20% de las sesiones de di\u00e1lisis se acompa\u00f1an de calambres musculares (1)<\/li>\n
  • Los calambres son m\u00e1s pronunciados en pacientes que requieren altas tasas de ultrafiltraci\u00f3n y posiblemente se dializan por debajo de su peso seco. Es de suponer que est\u00e1n relacionados con la reducci\u00f3n de la perfusi\u00f3n muscular que se produce en respuesta a la hipovolemia. Las respuestas vasoconstrictoras compensatorias pueden derivar la sangre de forma centralizada durante el tratamiento y podr\u00edan desempe\u00f1ar un papel en la promoci\u00f3n de los calambres musculares (2).<\/li>\n
  • Los cambios en el equilibrio intra o extracelular de potasio y la concentraci\u00f3n de calcio ionizado pueden alterar la transmisi\u00f3n neuromuscular y producir calambres.<\/li>\n
  • Cambios en la osmolalidad s\u00e9rica y la concentraci\u00f3n de Na+<\/sup> durante la hemodi\u00e1lisis<\/li>\n
  • La enfermedad vascular perif\u00e9rica, aunque es com\u00fan en pacientes en di\u00e1lisis, puede no estar asociada con una mayor prevalencia de calambres intradial\u00edticos, lo que confirma que los procesos relacionados con el tratamiento dial\u00edtico son responsables de los calambres (3)<\/li>\n<\/ul>\n

    Diagn\u00f3stico diferencial<\/strong><\/h4>\n

    Si bien la mayor\u00eda de los calambres est\u00e1n asociados con el tratamiento de di\u00e1lisis, el diagn\u00f3stico diferencial es extenso e incluye las siguientes condiciones:<\/p>\n

      \n
    • Calambres idiop\u00e1ticos<\/li>\n
    • Contracturas (que ocurren en afecciones como miopat\u00edas metab\u00f3licas y enfermedad de la tiroides)<\/li>\n
    • Tetania (debido a hipocalcemia o alcalosis)<\/li>\n
    • Distonias (calambres ocupacionales, medicamentos antipsic\u00f3ticos)<\/li>\n
    • Otros problemas de las piernas, como los s\u00edndromes de piernas inquietas y los movimientos peri\u00f3dicos de las piernas, deben distinguirse de los calambres (4)<\/li>\n<\/ul>\n

      Tratamiento y Prevenci\u00f3n<\/strong><\/h4>\n
        \n
      • Muchas de las estrategias de tratamiento son similares a las que se utilizan para tratar la hipotensi\u00f3n intradial\u00edtica (2)<\/li>\n
      • Las maniobras f\u00edsicas como el masaje de los m\u00fasculos de la pantorrilla y la dorsiflexi\u00f3n del pie no son muy \u00fatiles (2)<\/li>\n
      • El tratamiento inmediato consiste en aumentar el volumen intravascular interrumpiendo o ralentizando la ultrafiltraci\u00f3n y administrando soluci\u00f3n salina, manitol o glucosa. Adem\u00e1s de afectar un desplazamiento intravascular de agua, las soluciones hipert\u00f3nicas pueden mejorar directamente el flujo sangu\u00edneo a los m\u00fasculos (2)<\/li>\n
      • El uso de modelado de sodio, potasio o calcio de dializado puede ser \u00fatil. El concepto de individualizaci\u00f3n de la composici\u00f3n del dializado puede ser preventivo (2)<\/li>\n
      • Reevaluaci\u00f3n cuidadosa del peso seco, aconsejando al paciente que reduzca el aumento de peso interdial\u00edtico y usando di\u00e1lisis con bicarbonato (2)<\/li>\n
      • Se han probado carnitina, quinina, prazocina, vitamina E, vitamina C y extracto de hierbas japonesas con resultados variables (5,6)<\/li>\n<\/ul>\n
        <\/div>
        <\/div>\n

        References:<\/h4>\n
          \n
        1. Wilkinson R, Barber SG, Robson V. Cramps, thirst and hypertension in hemodialysis patients — the influence of dialyzate sodium concentration. Clin Nephrol<\/em>. 1977;7(3):101-105. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/870266.<\/li>\n
        2. Boudville N, Blake PG. Volume Status and Fluid Overload in Peritoneal Dialysis. In: Daugirdas JT, Blake PG, Ing TS, eds. Handbook of Dialysis<\/em>. fifth. Philadelphia: Walters Kluwer Health; 2015:484-485.<\/li>\n
        3. Brass EP, Adler S, Sietsema KE, Amato A, Esler A, Hiatt WR. Peripheral arterial disease is not associated with an increased prevalence of intradialytic cramps in patients on maintenance hemodialysis. Am J Nephrol<\/em>. 2002;22(5-6):491-496. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12381949.<\/li>\n
        4. Riley JD, Antony SJ. Leg cramps: differential diagnosis and management. Am Fam Physician<\/em>. 1995;52(6):1794-1798. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/7484689.<\/li>\n
        5. Ahmad S. L-carnitine in dialysis patients. Semin Dial<\/em>. 2001;14(3):209-217. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11422928.<\/li>\n
        6. Mandal AK, Abernathy T, Nelluri SN, Stitzel V. Is quinine effective and safe in leg cramps? J Clin Pharmacol<\/em>. 1995;35(6):588-593. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/7665718.<\/li>\n<\/ol>\n<\/div>\n
          \n

          P\/N 103062-01S Rev A 02\/2023<\/p>\n

          <\/div>\n<\/div>\n","protected":false},"featured_media":0,"template":"","format":"standard","meta":{"_acf_changed":false},"categories":[274],"tags":[218],"language":[42],"articles":[272],"class_list":["post-5792","article","type-article","status-publish","format-standard","hentry","category-articulos","tag-intradialytic-sp","language-spanish","articles-hemodialisis","entry","no-media"],"acf":[],"yoast_head":"\nCalambres - Advanced Renal Education Program<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Calambres - Advanced Renal Education Program\" \/>\n<meta property=\"og:description\" content=\"Etiolog\u00eda Aproximadamente el 20% de las sesiones de di\u00e1lisis se acompa\u00f1an de calambres musculares (1) Los calambres son m\u00e1s pronunciados en pacientes que requieren altas tasas de ultrafiltraci\u00f3n y posiblemente se dializan por debajo de su peso seco. Es de…\" \/>\n<meta property=\"og:url\" content=\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/\" \/>\n<meta property=\"og:site_name\" content=\"Advanced Renal Education Program\" \/>\n<meta property=\"article:modified_time\" content=\"2025-05-09T16:15:03+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/\",\"name\":\"Calambres - Advanced Renal Education Program\",\"isPartOf\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website\"},\"datePublished\":\"2023-08-25T00:49:46+00:00\",\"dateModified\":\"2025-05-09T16:15:03+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Calambres\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/\",\"name\":\"Advanced Renal Education Program\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization\",\"name\":\"Advanced Renal Education Program\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg\",\"contentUrl\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg\",\"width\":1965,\"height\":381,\"caption\":\"Advanced Renal Education Program\"},\"image\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Calambres - Advanced Renal Education Program","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/","og_locale":"en_US","og_type":"article","og_title":"Calambres - Advanced Renal Education Program","og_description":"Etiolog\u00eda Aproximadamente el 20% de las sesiones de di\u00e1lisis se acompa\u00f1an de calambres musculares (1) Los calambres son m\u00e1s pronunciados en pacientes que requieren altas tasas de ultrafiltraci\u00f3n y posiblemente se dializan por debajo de su peso seco. Es de…","og_url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/","og_site_name":"Advanced Renal Education Program","article_modified_time":"2025-05-09T16:15:03+00:00","twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/","name":"Calambres - Advanced Renal Education Program","isPartOf":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website"},"datePublished":"2023-08-25T00:49:46+00:00","dateModified":"2025-05-09T16:15:03+00:00","breadcrumb":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/calambres-sp\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/ami.advancedrenaleducation.com\/wparep\/"},{"@type":"ListItem","position":2,"name":"Calambres"}]},{"@type":"WebSite","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/","name":"Advanced Renal Education Program","description":"","publisher":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/ami.advancedrenaleducation.com\/wparep\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization","name":"Advanced Renal Education Program","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg","contentUrl":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg","width":1965,"height":381,"caption":"Advanced Renal Education Program"},"image":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/"}}]}},"distributor_meta":false,"distributor_terms":false,"distributor_media":false,"distributor_original_site_name":"Advanced Renal Education Program","distributor_original_site_url":"https:\/\/ami.advancedrenaleducation.com\/wparep","push-errors":false,"_links":{"self":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/article\/5792","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/article"}],"about":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/types\/article"}],"wp:attachment":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/media?parent=5792"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/categories?post=5792"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/tags?post=5792"},{"taxonomy":"language","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/language?post=5792"},{"taxonomy":"articles","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/articles?post=5792"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}