Clinical management of restless legs syndrome in end-stage renal disease patients

CNS Spectr. 2017 Feb;22(1):14-21. doi: 10.1017/S109285291600064X. Epub 2016 Oct 5.

Abstract

Restless legs syndrome (RLS) is a common neurological movement disorder, characterized by restless and unpleasant sensations in the deep inside of legs. The symptoms of RLS are less noticeable during daytime, but more prevalent at night. Therefore, the disorder can induce low quality of life, insomnia, and impairment of daytime activity. RLS in end-stage renal disease (ESRD) patients is especially problematic due to premature discontinuation of dialysis and increased mortality. The prevalence of RLS among dialysis patients is much higher compared to the prevalence of the same disorder in patients with normal renal functions. Even though there are recommended treatment guidelines for the general population established by Medical Advisory Board of the RLS foundation, which include the use of dopamine agonists, levodopa, gabapentin, benzodiazepines, and opioids, limited information is available on the effects of these therapies in ESRD patients. Since the existing clinical data were extrapolated from small sample sizes in short-term clinical trials, further clinical studies are still needed to better assess the efficacy, safety, and tolerability of these medications in patients with ESRD.

Keywords: Benzodiazepines; dopamine; end-stage renal disease; gabapentin; opioid; periodic limb movement disorder; restless legs syndrome.

Publication types

  • Review

MeSH terms

  • Amines / therapeutic use
  • Analgesics, Opioid / therapeutic use*
  • Benzodiazepines / therapeutic use
  • Benzothiazoles / therapeutic use
  • Comorbidity
  • Cyclohexanecarboxylic Acids / therapeutic use
  • Dopamine Agonists / therapeutic use*
  • Excitatory Amino Acid Antagonists / therapeutic use*
  • Exercise Therapy
  • Gabapentin
  • Humans
  • Indoles / therapeutic use
  • Intermittent Pneumatic Compression Devices
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / therapy*
  • Levodopa / therapeutic use
  • Massage
  • Pramipexole
  • Quality of Life
  • Renal Dialysis*
  • Restless Legs Syndrome / epidemiology
  • Restless Legs Syndrome / therapy*
  • Sleep Hygiene
  • Tetrahydronaphthalenes / therapeutic use
  • Thiophenes / therapeutic use
  • gamma-Aminobutyric Acid / therapeutic use

Substances

  • Amines
  • Analgesics, Opioid
  • Benzothiazoles
  • Cyclohexanecarboxylic Acids
  • Dopamine Agonists
  • Excitatory Amino Acid Antagonists
  • Indoles
  • Tetrahydronaphthalenes
  • Thiophenes
  • ropinirole
  • Benzodiazepines
  • Levodopa
  • gamma-Aminobutyric Acid
  • Gabapentin
  • Pramipexole
  • rotigotine