Restless legs syndrome in end-stage renal disease: Clinical characteristics and associated comorbidities

Sleep Med. 2010 Sep;11(8):785-90. doi: 10.1016/j.sleep.2010.02.011. Epub 2010 Jul 27.


Background: Despite being frequently described in patients with end-stage renal disease (ESRD), clinical characteristics and comorbidities in association with restless legs syndrome (RLS) are still to be confirmed.

Objectives: The aim of this study was to investigate clinical factors associated with RLS in ESRD patients in hemodialysis.

Methods: This is a cross-sectional study of 400 patients on hemodialysis, evaluating RLS, clinical features and other sleep abnormalities.

Results: Out of 400, 86 patients presented RLS (21.5%; mean age 48.8+/-13.8y), being more frequent in females (p<0.005). Forty-eight individuals (12% mean age 50.7+/-13.1y) had moderate/severe RLS, 14 reported symptoms prior to hemodialysis, 13 described family history of RLS, and eight described symptoms as disturbing during dialysis. RLS cases showed lower hemoglobin (p<0.005), poorer quality of sleep (Pittsburgh Sleep Quality Index >5, p=0.002), higher scores on the Beck Depression Inventory Scale (p<0.005), greater scores on the Charlson Comorbidity Index (p=0.01) and the Epworth Sleepiness Scale (p=0.001) and higher risk of obstructive sleep apnea (OSA; Berlin questionnaire, p=0.01). Hypertension was more frequent in cases with moderate/severe RLS (p=0.01) and remained after controlling for the risk of OSA (p=0.02).

Conclusion: In ESRD patients in hemodialysis, RLS is present in 21.5%; 16% report symptoms prior to hemodialysis and a family history of RLS. Symptoms are disturbing during hemodialysis in 9% of cases. RLS is associated with lower hemoglobin, worse sleep quality, excessive daytime sleepiness, depressive symptoms and higher risk of OSA. Hypertension is associated with moderate/severe RLS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / physiopathology
  • Female
  • Humans
  • Hypertension, Renal / epidemiology*
  • Hypertension, Renal / physiopathology
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Renal Dialysis / statistics & numerical data
  • Restless Legs Syndrome / epidemiology*
  • Restless Legs Syndrome / physiopathology
  • Risk Factors
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Stages
  • Surveys and Questionnaires
  • Young Adult