Factors Causing the Restless Leg Syndrome in CKD 5 and ESRD Patients on Maintenance Hemodialysis

Abstract

Introduction: A common neurological illness, restless legs syndrome (RLS) can occur alone or in conjunction with other conditions. Uncomfortable or unusual feelings inside the arms or legs, along with a need to move the limbs, are hallmarks of RLS symptoms. Movement can momentarily alleviate the symptoms, which typically manifest during rest and at night. RLS negatively affects quality of life and is linked to mood disorders as despair and anxiety.

Study type: Descriptive, cross sectional study.

Settings: Department of Medicine, Creek General Hospital & United Hospital, Karachi.

Materials & Methods: Total 126 male and female with chronic kidney disease (CKD) having restless leg syndrome, age range between 20-80 years of age and suffering from a disease for at least ≥ 3 months and on hemodialysis were included. Patients who were on intermittent or peritoneal dialysis, had conditions like neuropathy, radiculopathy, venous insufficiency, myalgia, leg edema, or arthritis that could mimic restless legs syndrome, were taking medications that can affect symptoms like dopamine agonists, antagonists, or anticonvulsants, were pregnant or nursing, had mental health conditions or cognitive impairments that made it difficult to understand the study, or had mobility-limiting conditions like recent fractures or amputations were excluded. A self-made proforma was created, including demographic information including age, gender, BMI, and length of symptoms, as well as a history of alcohol and tobacco use.

Results: My study found that the following factors were most common in CKD 5 and ESRD patients receiving maintenance hemodialysis: male gender (66.67%), diabetes mellitus (45.24%), hypertension (58.73%), obesity (35.71%), smoking (42.86%), anemia (23.22%), and alcohol consumption (19.84%).

Conclusion: According to this study, about half of hemodialysis patients suffer from restless legs syndrome, indicating a significant burden of this neurological consequence. Significant predictors of the development of restless legs syndrome included male gender, diabetic nephropathy, afternoon dialysis timing, and extended dialysis duration.