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The Kidney Connection - Restless Legs Syndrome
EasyLink Access #: 171
Restless legs syndrome (RLS) is a movement disorder that causes uncomfortable, unpleasant sensations in the legs. It affects up to 10% of the US population and as many as 40% of those on dialysis. The condition mostly affects older individuals. Currently, clinicians are looking at whether or not RLS may have something to do with the neurotransmitters (brain chemicals) that help regulate the movements of the muscles. They are also studying central nervous system abnormalities that control automatic movements. Symptoms of RLS Symptoms of RLS include the following feelings: - Aching;
- Burning;
- "Creepy-crawly";
- Itching;
- Prickling;
- Being on "pins and needles"; and
- Jerking movements.
RLS symptoms are often noticed more at night when you are trying to sleep and can cause insomnia. Generally, the symptoms are more acute during the night and less severe in the morning. They can also occur if you have been sitting down for longer than usual. Some patients have these feelings while in their dialysis chairs, which can make their treatments unpleasant. What is the Link to Kidney Disease? RLS has been linked to such conditions as chronic kidney disease (CKD), anemia (a very common condition among CKD patients), inadequate dialysis, nerve damage from diabetes (the number one cause of CKD), arthritis, and vitamin deficiency, among other factors. Stress, worry, and fatigue can worsen the symptoms. Some studies have indicated that RLS patients had low parathyroid hormone (PTH) levels. Those with kidney disease are at a higher risk for bone disease. Therefore, your doctor should monitor your PTH level to make sure it is within its proper range. Another factor may be related to psychiatric and neurological drugs. RLS, however, is often either not recognized or is misdiagnosed since many conditions can mimic it. It would also help healthcare professionals to know the difference between RLS and a painful condition called peripheral neuropathy (nerve damage to the arms and legs). This is a common condition in kidney patients, but does not worsen at night or is improved by movement. What Can You Do? There is no known test for RLS, so, if you experience any of the symptoms, write them down for your doctor. What do these symptoms feel like? When do they occur? What makes them better or worse? Also, make sure your red blood cell and iron levels are high enough. Get enough dialysis, and never skip or shorten your treatments. Ask your dialysis staff what you can do to help relieve your symptoms when you are being treated. Stick to your renal diet, and eat balanced meals. Stop smoking and drinking caffeine and alcohol. Other things you can try include massage, hot or cold baths, warm or cold compresses, relaxation techniques, changes to your sleep habits, mild exercise, electric nerve stimulation, acupuncture, and meditation. (Note: always check with your doctor before trying these suggestions.) More Information For more information, log onto the following websites: - American Academy of Sleep Medicine, www.aasmnet.org/hygiene.asp.
- DaVita, www.davita.com/articles/ckd/index.shtml?id=895.
- Life Options Rehabilitation Program, www.lifeoptions.org/catalog/pdfs/teaching/legs.pdf.
- National Heart, Lung, and Blood Institute, National Institutes of Health. "Facts About Restless Legs Syndrome" article can be downloaded from: www.nhlbi.nih.gov/health/public/sleep/rls.htm.
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, www.ninds.nih.gov/disorders/restless-legs/detail-restless-legs.htm.
- National Sleep Foundation, www.sleepfoundation.org.
- Restless Legs Syndrome Foundation, www.rls.org.
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