Interventions for chronic kidney disease-associated restless legs syndrome.
Gopaluni S, Sherif M, et al.Cochrane Database of Systematic Reviews 2016; 11: CD010690.
Aims
To look at the benefits, efficacy and safety of various treatment options used in the treatment of restless legs syndrome (RLS) in people with chronic kidney disease (CKD) and those undergoing renal replacement therapy (RRT) to assess the applicability of particular interventions to individual patients.
Interventions
The Cochrane Kidney and Transplant Specialised Register, which contains studies identified from CENTRAL, MedLine, Embase, the International Clinical Trials Register, selected kidney and kidney-related journals and the proceedings of major kidney conferences, was searched up until 12 January 2016. All randomised controlled trials (RCTs) and quasi-RCTs looking at the specified therapeutic interventions for people with RLS associated with CKD stages 3 to 5, including different modes of RRT were included.
Participants
9 RCTs were included in the analysis which involved 220 participants undergoing RRT.
Outcomes
The primary outcomes measured were the effects of the intervention in reducing symptom severity due to RLS in people with CKD, and potential complications. Secondary outcomes measured were improvements in quality of life and quality of sleep, reduction in cardiovascular mortality and applicability to individual patients.
Follow-up
2-6 months
CET Conclusions
This Cochrane review investigated the role of interventions for restless leg syndrome (RLS) in CKD patients, including those with renal transplants. Nine studies were identified, all in haemodialysis patients, with moderate study quality overall. Interventions identified were heterogeneous, including exercise, gabapentin, ropinerole, levodopa, iron dextran and vitamins C and E. All interventions studied reduced severity of RLS compared to controls. Whilst the methodology (as expected from a Cochrane review) is sound, it is difficult to draw any firm conclusions from this heterogeneous group of studies. Each study was small and investigated a different intervention/group of interventions. Included studies were mainly in haemodialysis patients (one study also recruited peritoneal dialysis patients) so no conclusions can be drawn about earlier stages of CKD (pre-dialysis) or transplant recipients.
Quality notes
Quality assessment not appropriate
Trial registration
None