Kidney disease seems to have affected me by the reduction of my calf muscles. I never have had low albumin so it doesnt seem to be due to a loss of protein. My muscles aren't affected anywhere else. Is this condition common to most kidney patients?

Janice:

Patients with ESRD who are receiving dialysis may develop muscle weakness that predominantly affects the lower extremities. Interestingly, serum muscle enzymes are usually within normal range. Oftentimes, further tests reveal a type II fiber atrophy. Unfortunately, this can be caused from many different things.

Causes of muscle weakness in dialysis patients:

Peripheral neuropathy
Vitamin D deficiency
Hyperparathyroidiam
Carnitine deficiency
Aluminum intoximcation
Hyperkalemia or hypokalemia
Acidosis
Iron overlaod
Server hypophosphatemia
Drug toxicity
Muscle ischemia due to vascular calcification
Inactivity
Underlying systemic rheumatic disease

(From: Handbook of Dialysis, Third Edition, 2001)

I hope this helps a bit. Please let me know if you would like further information.

Carol

I've heard of carnitine deficiencey. Should all dialysis patients take carnitor then or just certain ones? As far as the rest of the long list of possibilites, how does one narrow this down and find the true individual cause/s? I see now how this muscle deterioration occurred prior to my ESRD diagnosis and also is connected to RLS. Is there a way of determining which problems on the list a patient has and developing a program of care, or is this a permanent condition? The dialysis treatment exaserbates it, whether it's the long hours of sitting or the tx itself. Something strange is the fact that I don't have problems from the muscle weakness everytime I'm on tx. so that tells me there are certain factors that influence it. My dietitian told me the calve muscles can be built back up, but I need more info on how, and what's causing what here.

My personal opinion (and it is just that) is that the only patients who should take Carnitor are those who have been diagnosed with a carnitine deficiency. There are several theories abounding about the use of carnitine in dialysis patients, and many good outcomes from those who have used it. Carnitor actually has a web page with some of this information on it. It may be found at: http://www.carnitor.com/.

My suggestion on narrowing the rest of the list would be to talk to your physician about your complaints. He or she may want to run some tests to help determine the cause of your muscle atrophy, or may decide to simply keep an eye on it.

If you do have RLS, I would also refer you to the restless leg syndrome web page. It may be found at: http://restlesslegs.com/.

I hope this helps. Please talk to your physician, and let us know how things turn out for you.

Carol