Restless legs syndrome in chronic renal failure patients on dialysis

Carin Behrens van Tonder; Gina Joubert; Anand Moodley

doi:10.4314/ahs.v23i3.88

Restless legs syndrome in chronic renal failure patients on dialysis

Afr Health Sci. 2023 Sep;23(3):764-777. doi: 10.4314/ahs.v23i3.88.

Authors

Carin Behrens van Tonder¹, Gina Joubert², Anand Moodley³

Affiliations

¹ Department of Neurology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
² Department of Biostatistics, School of Biomedical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
³ Department of Neurology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Abstract

Background: Restless legs syndrome (RLS) occurs in patients with chronic renal failure (CRF).

Objectives: To determine the prevalence and morbidity of RLS in CRF patients on dialysis.

Methods: This cross-sectional questionnaire-based study included 100 dialysis patients (50 on haemodialysis [HD]; 50 on peritoneal dialysis [PD]). A focused lower limb examination was done. Patients were classified with RLS when reporting uncomfortable feelings in their legs that improved with movement and worsened when resting and at night.

Results: Gender distribution was equal. The median age was 43 (19-67) years. Six patients (HD and PD n=3 each) had international criteria-confirmed RLS. Twenty-four patients reported symptoms suggestive of RLS. Fourteen and 16 patients with RLS symptoms were on HD and PD, respectively. Sleep disturbances occurred in 43.3% (n=13) of patients with RLS symptoms, compared to 20.0% (n=20) of the large cohort. Sleep disturbances, peripheral sensory loss, chronic disease-related anaemia, increased urea and decreased albumin levels were more common among patients with RLS symptoms.

Conclusion: RLS symptoms occurred in 30.0% of the entire cohort, although only 6.0% met the international criteria. The type of dialysis had no impact on the incidence of symptoms. Identifying RLS in patients with CRF on dialysis will allow for early intervention.

Keywords: Restless legs syndrome; chronic renal failure; haemodialysis; peritoneal dialysis; symptoms.

MeSH terms

Adult
Cross-Sectional Studies
Humans
Kidney Failure, Chronic* / complications
Kidney Failure, Chronic* / epidemiology
Kidney Failure, Chronic* / therapy
Renal Dialysis / adverse effects
Renal Insufficiency, Chronic* / complications
Restless Legs Syndrome* / epidemiology
Restless Legs Syndrome* / etiology