Abstract
Restless Leg Syndrome (RLS), or Willis-Ekbom disease (WED), is an irresistible urge to move the legs, predominantly while resting, sitting, or sleeping, which disrupts sleep and impairs quality of life. RLS can occur secondary to uremia in chronic kidney disease (CKD) patients due to inadequate hemodialysis. Early diagnosis is essential to prevent muscular atrophy and to improve the quality of life of RLS patients, especially those with end-stage renal disease (ESRD). Cardiac mortality high in uremic RLS patients due to associated discomfort and lowering the duration of hemodialysis treatment. This review focuses on and discusses the diagnosis, treatment, and associated comorbid conditions of uremic RLS. Though the exact pathophysiology is unknown, altered transferrin expression in the choroid plexus, increased glutamate levels in the thalamus, decreased opioid receptors, dopamine system dysfunction, calcium/phosphate imbalance, and single nucleotide polymorphisms in the BTBD9 and MEIS1 genes are a few nonconfirmatory pathophysiological concepts for uremic RLS. Nonpharmacological options include lowering the temperature of dialysate by 1 degree C and home-based therapies like massages, warm/cold baths, and aerobic exercises. Pharmacological therapy like dopamine agonists ropinirole and pramipexole reduces the symptoms effectively. However, surgical options like parathyroidectomy and renal transplantation are stated as the best treatment options in patients suffering from uremic RLS.
Highlights
BackgroundReceived 07/28/2020 Review began 08/13/2020 Review ended 08/16/2020Published 0S8t/u23d/2y020Restless Leg Syndrome (RLS) is one of the most unrecognized chronic sensory-motor disorders in renal failure patients [1]
The prevalence in patients undergoing hemodialysis therapy ranges from 8.8-83%, and the frequency of RLS in end-stage renal disease (ESRD) patients among different countries over the last 10 years is shown in Table 1 [3,4]
Renal failure and ESRD patients on hemodialysis constitute a large group of the population that are likely to be affected by RLS because of severe uremia
Summary
BackgroundReceived 07/28/2020 Review began 08/13/2020 Review ended 08/16/2020Published 0S8t/u23d/2y020Restless Leg Syndrome (RLS) is one of the most unrecognized chronic sensory-motor disorders in renal failure patients [1]. Diagnosis is essential to prevent muscular atrophy and to improve the quality of life of RLS patients, especially those with end-stage renal disease (ESRD). Cardiac mortality high in uremic RLS patients due to associated discomfort and lowering the duration of hemodialysis treatment. This review focuses on and discusses the diagnosis, treatment, and associated comorbid conditions of uremic RLS.
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