Evaluation of effect of renal transplantation in treatment of restless legs syndrome

BACKGROUND: Restless legs syndrome (RLS) is a common cause of sleep disturbance frequently experienced by hemodialysis patients. It is a neurological movement disorder. Patients with RLS suffer an irresistible urge to move the legs during inactivity with relief by motion and various activities. MATERIALS AND METHODS: We investigated the clinical course of RLS in 30 (12 female and 18 male) hemodialysis patients with mean dialysis duration of 16.8 +/- 14.13 months who underwent kidney transplantation. Patients were given a standardized questionnaire evaluating details of RLS at baseline and twice after kidney transplantation. They were diagnosed to have RLS by International RLS Study Group criteria. Biochemical (serum calcium, phosphate, Na, and K and blood urea and creatinine) and hematological indices (serum iron, hemoglobin) were measured at each time. RESULTS: RLS in hemodialysis patients was significantly reduced by renal transplantation (43.3%; P<.0001). There was a significant association between RLS and lower serum iron (P<.01) and phosphorus (P<.02) after renal transplantation: We did not observe any association between hemoglobin levels, age, sex, dialysis duration, and time after transplantation with RLS. CONCLUSION: Kidney transplantation showed a strong, positive influence on RLS symptoms in hemodialysis patients. Correction of serum phosphate and serum iron (by mechanisms different than its effect on hemoglobin) can affect RLS in kidney transplant patients.