International Urology and Nephrology

, Volume 49, Issue 9, pp 1673–1679 | Cite as

Insomnia, muscular cramps and pruritus have low intensity in hemodialysis patients with good dialysis efficiency, low inflammation and arteriovenous fistula

  • Olga Hilda Orasan
  • Aniela Pop Saplontai
  • Angela Cozma
  • Simona Racasan
  • Ina Maria Kacso
  • Crina Claudia Rusu
  • Diana Moldovan
  • Dacian Tirinescu
  • Alina Potra
  • Ioan Mihai Patiu
  • Remus Aurel Orasan
Nephrology - Original Paper



Insomnia, muscular cramps, pruritus and postdialysis recovery time (RT) are quality-of-life parameters that affect hemodialysis (HD) patients physically and mentally.


We included 171 end-stage renal disease patients: 115 on high-flux HD and 56 on online hemodiafiltration (HDF). Patients were asked “How long does it take you to recover from a dialysis session?” and they evaluated intensity (absent, mild, medium and severe) of insomnia, muscular cramps and pruritus in the past 4 weeks. We sought associations of RT, insomnia, muscular cramps and pruritus with themselves and age, dialysis vintage, sex, body mass index, hemoglobin, albumin, C-reactive protein (CRP), Daugirdas single-pool Kt/V (Kt/V), ultrafiltration volume, blood processed volume and vascular access type.


Insomnia absence correlated with muscular cramps absence (p = 0.01), arteriovenous fistula (AVF) presence (p = 0.02) and lower CRP (p = 0.003). Muscular cramps absence associated pruritus absence (p = 0.007) and AVF (p = 0.001). Absent pruritus patients were younger (p = 0.04), had higher Kt/V (p = 0.01) and more AVF (p = 0.02). Men insomnia was more severe in HD than HDF and albumin related (p = 0.007), while CRP was lower in absent pruritus. Women insomnia associated with muscular cramps (p = 0.04) and vascular access (p = 0.03), as was pruritus (p = 0.03). RT had no relations with any parameter.


HD patients with AVF have less insomnia, muscular cramps and pruritus. Insomnia is associated with muscular cramps and inflammation. Pruritus is worse in older patients, is diminished with increased dialysis efficiency and is associated with higher CRP in men. There is no difference between HD and HDF patients, except more severe insomnia for HD in men.


Insomnia Muscular cramps Pruritus Posthemodialysis recovery time Hemodialysis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  • Olga Hilda Orasan
    • 1
  • Aniela Pop Saplontai
    • 2
  • Angela Cozma
    • 1
  • Simona Racasan
    • 3
  • Ina Maria Kacso
    • 4
  • Crina Claudia Rusu
    • 4
  • Diana Moldovan
    • 4
  • Dacian Tirinescu
    • 4
  • Alina Potra
    • 4
  • Ioan Mihai Patiu
    • 3
  • Remus Aurel Orasan
    • 3
  1. 1.4th Medical DepartmentUniversity of Medicine and Pharmacy “Iuliu Hatieganu”Cluj-NapocaRomania
  2. 2.5th Medical DepartmentUniversity of Medicine and Pharmacy “Iuliu Hatieganu”Cluj-NapocaRomania
  3. 3.Nefromed Dialysis CenterCluj-NapocaRomania
  4. 4.Department of NephrologyUniversity of Medicine and Pharmacy “Iuliu Hatieganu”Cluj-NapocaRomania

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