title: Current trends in the management of uremic restless legs syndrome: a systematic review on aspects related to quality of life, cardiovascular mortality and survival.
abstract: Restless legs syndrome (RLS) affects almost one out of three end-stage renal disease patients. This review assesses the current treatment options for uremic RLS and the potential benefits of those treatments on quality of life parameters, cardiovascular mortality and survival. A systematic review was conducted searching PubMed and Scopus by using the Cochrane and PRISMA guidelines. Fourteen studies met the inclusion criteria in which the international RLS study group criteria were used as the primary diagnostic tool. Both pharmacological and non-pharmacological approaches were found to reduce the severity of uremic RLS symptoms. Only four studies reported changes on aspects related to quality of life while those changes were also associated with health benefits that resulted in reduced cardiovascular risk. The severity of uremic RLS symptoms can be ameliorated by using dopamine agonists and gabapentin, intravenous iron, exercise or supplementation with vitamins C and E, although some of those treatment benefits may be transient. There is a lack of strong evidence regarding the effects of the pharmacological approaches on quality of life and cardiovascular survival and mortality. In contrast exercise has been proven beneficial in both reducing the RLS symptoms' severity score and improving the quality of life.
authors.affiliation: School of PE and Sports Science, University of Thessaly, Trikala, Greece; Department of Nephrology, Faculty of Medicine, University of Thessaly, Larissa, Greece. Electronic address: gsakkas@med.uth.gr.
authors.forename: Giorgos K
authors.initials: GK
authors.lastname: Sakkas
authors.affiliation: Department of Life & Health Sciences, University of Nicosia, Cyprus.
authors.forename: Christoforos D
authors.initials: CD
authors.lastname: Giannaki
authors.affiliation: School of PE and Sports Science, University of Thessaly, Trikala, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Karatzaferi
authors.affiliation: Department of PE and Sport Science, University of Athens, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Maridaki
authors.affiliation: School of PE and Sports Science, University of Thessaly, Trikala, Greece.
authors.forename: Yiannis
authors.initials: Y
authors.lastname: Koutedakis
authors.affiliation: Department of Neurology, Faculty of Medicine, University of Thessaly, Larissa, Greece.
authors.forename: Georgios M
authors.initials: GM
authors.lastname: Hadjigeorgiou
authors.affiliation: Department of Nephrology, Faculty of Medicine, University of Thessaly, Larissa, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Stefanidis
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D006801:Humans; D011788:Quality of Life; D012148:Restless Legs Syndrome / Q000150:complications / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D014511:Uremia / Q000150:complications* / Q000401:mortality
keywords: Dopamine agonists; End-stage renal disease; Exercise training; Gabapentin; Hemodialysis; Periodic limb movements; Sleep; Sleep disorders