Restless Legs Syndrome in Patients With Chronic Kidney Disease.
Symptoms of restless legs syndrome (RLS) are common in patients with chronic kidney disease (CKD) on dialysis; symptoms of RLS are estimated to affect up to 25% of patients on dialysis when the international RLS diagnostic criteria are applied. RLS is a neurologic disorder with a circadian rhythmicity characterized by an overwhelming urge to move the legs during rest, which can be relieved temporarily by movement. RLS has been associated with an increase in sleep disturbance, higher cardiovascular morbidity, decreased quality of life, and an increased risk of death in patients with CKD. Although the exact pathophysiology of RLS is unknown, it is thought to involve an imbalance in iron metabolism and dopamine neurotransmission in the brain. The symptoms of moderate to severe RLS can be treated with several pharmacologic agents; however, data specific to patients on dialysis with RLS are lacking. The purpose of this article is to examine the relationship between, and complications of, RLS and CKD both in dialysis and nondialysis patients, and discuss the treatment options for patients on dialysis with RLS.
University Health Network, Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary. Electronic address: marta.novak@uhn.ca.
Marta
M
Novak
Department of Psychiatry, Sleep Disorders Clinical Research Program, Massachusetts General Hospital, Boston, MA.
John W
JW
Winkelman
Division of Nephrology, University of New Mexico School of Medicine, Albuquerque, NM.
Mark
M
Unruh
D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D011788:Quality of Life; D006435:Renal Dialysis; D012148:Restless Legs Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors
Chronic kidney disease; dialysis; kidney transplantation; quality of life; restless legs syndrome; sleep