Dialysis Patients With Restless Leg Syndrome: Can We Relieve Their Suffering?

Salib, Marina; Memon, Areeba N; Gowda, Asavari S; Rallabhandi, Bhavana; Bidika, Erjola; Fayyaz, Hafsa; Cancarevic, Ivan

doi:10.7759/cureus.10053

Cited by 12 publications

(16 citation statements)

References 43 publications

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“…The following steps to the pharmacologic therapies shall consider the severity and impact of symptoms and the side effects 121. In contrast, Salib et al122 stated that we should consider their general condition, financial status, other comorbidities, and conditions unrelated to the kidneys. Figure 2 shows the different treatment modalities used in hemodialysis patients with RLS.…”

Section: Methodsmentioning

confidence: 99%

Restless Leg Syndrome in Hemodialysis Patients

et al. 2022

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Background: Restless legs syndrome (RLS) is a clinical entity characterized by sensory-motor manifestations commonly observed in end-stage renal illness. Evidence suggests that RLS is a multifactorial phenomenon that can be influenced by many critical factors, including genetic predisposition, dietary patterns, and deficiency in some vitamins. Iron metabolism disorders and metabolic derangements have been generally accepted as predisposing elements in RLS. Furthermore, both pharmacological and neuroimaging studies demonstrated dopamine deficiency and dopamine receptors decrease in basal ganglia during RLS.

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Section: Methodsmentioning

confidence: 99%

Restless Leg Syndrome in Hemodialysis Patients

et al. 2022

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“…Hemodialysis patients experiece a variety of bothersome clinical symptoms, such as carpal tunnel syndrome [ 6 , 7 ], restless leg syndrome [ 8 , 9 ], pruritus [ 8 , 10 ], poor appetite [ 8 , 11 , 12 ], anemia [ 13 ], and insomnia [ 14 ]. Some of these symptoms can be explained by the incomplete removal of middle high molecular weight uremic toxins during hemodialysis [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Medium Cut-Off Polyarylethersulfone and Polyvinylpyrrolidone Blend Membrane Dialyzers in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2022

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The use of medium cut-off (MCO) polyarylethersulfone and polyvinylpyrrolidone blend membrane is an emerging mode in hemodialysis. Recent studies have shown that MCO membranes exhibit a middle high molecular weight uremic toxin clearance superior to standard high flux hemodialysis. We conducted a systematic literature review and meta-analysis of randomized controlled trials to investigate whether MCO membranes efficiently increase the reduction ratio of middle molecules, and to explore the potential clinical applications of MCO membranes. We selected articles that compared beta 2-microglobulin (β2M), kappa free light chain (κFLC), lambda free light chain (λFLC), interleukin-6 (IL-6), and albumin levels among patients undergoing hemodialysis. Five randomized studies with 328 patients were included. The meta-analysis demonstrated a significantly higher reduction ratio of serum β2M (p < 0.0001), κFLC (p < 0.0001), and λFLC (p = 0.02) in the MCO group. No significant difference was found in serum IL-6 levels after hemodialysis. Albumin loss was observed in the MCO group (p = 0.04). In conclusion, this meta-analysis study demonstrated the MCO membranes’ superior ability to clear β2M, κFLC, and λFLC. Serum albumin loss is an issue and should be monitored. Further studies are expected to identify whether MCO membranes could significantly improve clinical outcomes and overall survival.

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“…13 It has been reported that RLS in patients on hemodialysis is also associated with the morbidity and mortality of cardiovascular diseases. 14,15 The pathogenesis may be related to factors such as hyperphosphatemia, transferrin saturation < 20%, lower hemoglobin level, insufficient erythropoietin response, chronic inflammation, and oxidative stress. 14,16 However, the specific pathogenesis needs further research.…”

Section: Introductionmentioning

confidence: 99%

“…14,15 The pathogenesis may be related to factors such as hyperphosphatemia, transferrin saturation < 20%, lower hemoglobin level, insufficient erythropoietin response, chronic inflammation, and oxidative stress. 14,16 However, the specific pathogenesis needs further research.…”

Section: Introductionmentioning

confidence: 99%

“…RLS in patients on hemodialysis not only affects patients' sleep disorders but also causes anxiety and sexual dysfunction 13 . It has been reported that RLS in patients on hemodialysis is also associated with the morbidity and mortality of cardiovascular diseases 14,15 . The pathogenesis may be related to factors such as hyperphosphatemia, transferrin saturation < 20%, lower hemoglobin level, insufficient erythropoietin response, chronic inflammation, and oxidative stress 14,16 .…”

Section: Introductionmentioning

confidence: 99%

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A network meta‐analysis of the effectiveness and safety of drugs for restless legs syndrome in dialysis patients

Tang

Sun

et al. 2021

Seminars in Dialysis

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Objective: To evaluate the efficacy and safety of nine pharmacological interventions for restless legs syndrome (RLS) in dialysis patients. Methods: An electronic database was used to retrieve eligible trials from PubMed, Cochrane, Embase, and Web of Science. Stata 14.2 software was used to perform network meta‐analysis. The primary measure was the RLS score, and the secondary measure was used to evaluate the side effects of the drug. The surface under the cumulative ranking curve method was used to rank the merits of intervention measures. A comparison of the two interventions is shown on a league table. Results: Finally, nine randomized controlled trials (RCTs) with a total of 377 participants were included. From the results of the network meta‐analysis, all treatments ranked higher than placebo in terms of improving clinical symptoms, but only vitamin C (standardized mean difference [SMD] = −1.47 95% confidence interval [CI] −2.89, −0.05) showed significant differences compared with placebo. In terms of safety, there were no serious adverse reactions to any of the treatments compared to placebo. Conclusion: Currently, existing evidence suggests that vitamin C may be the most ideal drug to improve the symptoms of RLS in dialysis patients.

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Dialysis Patients With Restless Leg Syndrome: Can We Relieve Their Suffering?

Cited by 12 publications

References 43 publications

Restless Leg Syndrome in Hemodialysis Patients

Restless Leg Syndrome in Hemodialysis Patients

Effects of Medium Cut-Off Polyarylethersulfone and Polyvinylpyrrolidone Blend Membrane Dialyzers in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

A network meta‐analysis of the effectiveness and safety of drugs for restless legs syndrome in dialysis patients

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