Role of Serum Electrolytes and Serum Vitamin D in Cirrhotic Patients with Muscle Cramps

Abstract

Background: Skeletal muscle cramps (MCs) are observed in around 29–88 % of patients who had liver cirrhosis (LC). This study aimed to evaluate the validity of measuring serum electrolytes (Na, K, Ca, Mg, and P) and vitamin D among cirrhotic patients who had skeletal muscle cramps.Patients and methods: We performed this case-control study on 72 patients with LC who were allocated into 2 groups: group A (case group of LC patients with skeletal MCs) and group B (control group of LC patients without skeletal MCs). Detailed history taking was collected from all patients; they underwent full clinical examination, pelviabdominal ultrasonography (US), and hematological and biochemical investigations, including measurement of serum electrolytes (Na, K, Ca, Mg, and P) and vitamin D.Results: Serum calcium and vitamin D levels were significantly less among group A than in group B (8.17 ± 0.53 mg/dL versus 8.48 ± 0.57 mg/dL; P=0.017 and 8.1ng/mL vs 18.45ng/mL; P <0.001 respectively). The best cutoff of serum vitamin D in the prediction of MCs among cases with LC is ≤ 12.6 ng/mL with the area under curve 0.87, sensitivity of 88.9 %, specificity of 77.8 %, positive predictive value of 80 %, negative predictive value of 87.5 % and overall accuracy 83.3 %; p < 0.001. Conclusion: The study findings suggested a substantial relationship between serum calcium and serum vitamin D and MCs in cirrhotic patients. No remarkable relationship was revealed between serum sodium, potassium, magnesium, and phosphorus with MCs in cirrhotic patients