My sister has recently been diagnosed with ESLD, stage 4 autoimmune cirrhosis. Her first meld score was 26 and, after two months medication, is 8. She is going through the process to get listed for transplant. She is having severe hand cramps and her finger hands (and sometime toes) cramp and cross over, looking deformed. She says its a pain level 20. Her first GI Doctor said he had no idea what it is, but I suspect it s due to related and/or new renal deficiencies. Do you know what could be causing this and if it could be severe or indicative of an emergency requiring attention?