Daily Hemodialysis Eases Restless Legs Syndrome

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SEATTLE—Daily hemodialysis (DHD) is associated with significant improvements in restless legs syndrome (RLS), a finding that confirms previously reported improvements in other measures of health-related quality of life, investigators reported here at the 30th Annual Dialysis Conference.

The finding emerged from the FREEDOM Study, which was designed to examine the impact of changing from conventional hemodialysis (HD) or peritoneal dialysis to six-times-a-week home HD using the NxStage HD machine.

The RLS analysis, led by Frederic O. Finkelstein, MD, Chief of Nephrology at the Hospital of St. Raphael and Clinical Professor of Medicine at Yale University in New Haven, Conn., included data from 147 patients who had a mean age of 52 years. The group was 66% white, 31%, black, and 3% other. In addition, 92% of patients were on HD prior to starting DHD.

Restless leg complains are common in end-stage renal disease patients on HD, the investigators noted. The presence of RLS has been associated with increased morbidity and mortality.

Dr. Finkelstein's group used the International Restless Legs Scale (IRLS) to examine how DHD impacts RLS. The IRLS consists of 10 items scored on a 0-4 scale. A patient's global score indicates RLS severity as follows: 1-10, mild; 11-20, moderate; 21-30, severe; and 31-40, very severe.

At baseline, the cohort had a mean global score of 14.8. At month 4 on DHD, the score decreased significantly to 11.4. At baseline, 40.9% of subjects had RLS; this proportion decreased significantly to 31.7% at month 4 on DHD.

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