The pharmacological treatment for uremic restless legs syndrome: Evidence-based review

Authors

  • Márcio Moysés de Oliveira MD, PhD,

    1. Department of Emergency Medicine and Evidence Based Medicine (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
    2. Brazilian Cochrane Center (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
    3. Sao Paulo Hospital Sleep Laboratory (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
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    • The first two authors contributed equally to this work.

  • Cristiane Fiquene Conti MD, PhD,

    1. Department of Emergency Medicine and Evidence Based Medicine (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
    2. Brazilian Cochrane Center (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
    3. Sao Paulo Hospital Sleep Laboratory (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
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    • The first two authors contributed equally to this work.

  • Juliana Spelta Valbuza PhD,

    1. Department of Emergency Medicine and Evidence Based Medicine (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
    2. Brazilian Cochrane Center (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
    3. Sao Paulo Hospital Sleep Laboratory (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
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  • Luciane Bizari Coin de Carvalho PhD,

    1. Department of Emergency Medicine and Evidence Based Medicine (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
    2. Sao Paulo Hospital Sleep Laboratory (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
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  • Gilmar Fernandes do Prado MD, PhD

    Corresponding author
    1. Department of Emergency Medicine and Evidence Based Medicine (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
    2. Sao Paulo Hospital Sleep Laboratory (UNIFESP), Universidade Federal de São Paulo, São Paulo, Brazil
    • Rua Claudio Rossi, 394 Sao Paulo – SP, CEP 01547-000, Brazil

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  • Potential conflict of interest: Nothing to report.

Abstract

Restless legs syndrome (RLS) is a common and often misdiagnosed entity among the general population and it may be more common among dialysis patients, with an estimated prevalence of 6.6 to 21.5%. The treatment for uremic RLS has been controversial and therefore a systematic synthesis of the evidence is needed in order to evaluate the effectiveness and safety of treatments for uremic RLS. This was a systematic review of randomized or quasi-randomized double-blind trials on treatments for uremic RLS. The outcomes considered were relief of RLS symptoms marked on a validated scale, subjective sleep quality, sleep quality measured using night polysomnography and actigraphy, quality of life measured subjectively, and adverse events associated with these treatments. Six eligible clinical trials were included. The results from subjective analyses in these studies were divergent, although objective analyses in one trial showed that there was a statistically significant improvement in periodic leg movement while asleep in the treatment group. No combined analysis (meta-analysis) was performed. The most common adverse event seen was gastrointestinal symptoms. Only a few therapeutic trials on patients with uremia with RLS have been published, and there is insufficient scientific evidence to favor any specific therapeutic regimen for uremic-associated RLS. Therapy using levodopa, dopaminergic agonists, anticonvulsants, and clonidine tend to be effective, but further studies are needed. © 2010 Movement Disorder Society

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