The pharmacological treatment for uremic restless legs syndrome: evidence-based review.
Restless legs syndrome (RLS) is a common and often misdiagnosed entity among the general population and it may be more common among dialysis patients, with an estimated prevalence of 6.6 to 21.5%. The treatment for uremic RLS has been controversial and therefore a systematic synthesis of the evidence is needed in order to evaluate the effectiveness and safety of treatments for uremic RLS. This was a systematic review of randomized or quasi-randomized double-blind trials on treatments for uremic RLS. The outcomes considered were relief of RLS symptoms marked on a validated scale, subjective sleep quality, sleep quality measured using night polysomnography and actigraphy, quality of life measured subjectively, and adverse events associated with these treatments. Six eligible clinical trials were included. The results from subjective analyses in these studies were divergent, although objective analyses in one trial showed that there was a statistically significant improvement in periodic leg movement while asleep in the treatment group. No combined analysis (meta-analysis) was performed. The most common adverse event seen was gastrointestinal symptoms. Only a few therapeutic trials on patients with uremia with RLS have been published, and there is insufficient scientific evidence to favor any specific therapeutic regimen for uremic-associated RLS. Therapy using levodopa, dopaminergic agonists, anticonvulsants, and clonidine tend to be effective, but further studies are needed.
de Oliveira
Márcio Moysés
MM
Department of Emergency Medicine and Evidence Based Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.
Conti
Cristiane Fiquene
CF
Valbuza
Juliana Spelta
JS
de Carvalho
Luciane Bizari Coin
LB
do Prado
Gilmar Fernandes
GF
D018592:Cross-Over Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D004311:Double-Blind Method; D019317:Evidence-Based Medicine; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012148:Restless Legs Syndrome / Q000150:complications* / Q000188:drug therapy*; D014511:Uremia / Q000188:drug therapy* / Q000209:etiology*