A growing body of research has highlighted a strong association between chronic kidney disease (CKD) and Restless Legs Syndrome (RLS), a neurological condition that significantly affects sleep and quality of life. Individuals undergoing dialysis are particularly vulnerable, as their risk of developing RLS is much higher due to complications like iron deficiency.
What Is Restless Legs Syndrome?
Restless Legs Syndrome, also known as Willis-Ekbom Disease, is a neurological condition that creates an uncontrollable urge to move the legs, particularly during periods of rest or inactivity. The discomfort is often described as crawling, itching, aching, or pulling sensations. These symptoms tend to worsen in the evening or at night and are usually relieved by movement.
While the legs are primarily affected, in some cases, the arms may also experience similar sensations. RLS can disrupt sleep and, over time, lead to mood disturbances, chronic fatigue, and impaired focus.
Why CKD Patients Are More at Risk
Research shows that nearly one in four people with chronic kidney disease suffer from RLS, with higher prevalence among those on hemodialysis. This increased risk is largely tied to iron deficiency, which is common in CKD patients due to factors like blood loss during dialysis, poor iron absorption, and ongoing inflammation.
Brain imaging and spinal fluid analysis in people with RLS reveal low iron concentrations, particularly in areas that regulate dopamine—a chemical essential for muscle control. In kidney disease, both absolute and functional iron deficiencies are often seen. Patients tend to have reduced levels of ferritin and transferrin saturation, along with elevated total iron-binding capacity (TIBC), indicating iron imbalance that may directly contribute to RLS symptoms.
Recognising the Symptoms
The symptoms of RLS vary in intensity but commonly include:
Causes Beyond Kidney Disease
While many RLS cases are linked to CKD and iron deficiency, other health conditions also contribute. These include diabetes, peripheral neuropathy, and neurological disorders involving dopamine pathways, such as Parkinson’s disease. Genetics also play a role, as the condition is known to run in families. In some individuals, no specific cause can be identified.
Managing RLS: Treatment and Lifestyle Support
Though there is currently no cure for RLS, various treatments can help manage symptoms. Addressing iron deficiency through supplementation, where appropriate, is often a primary focus in CKD patients. Limiting stimulants like caffeine, alcohol, and tobacco—especially in the evening—can also reduce symptom flare-ups.
Other helpful strategies include:
( Originally published on Jun 20, 2025 )
What Is Restless Legs Syndrome?
Restless Legs Syndrome, also known as Willis-Ekbom Disease, is a neurological condition that creates an uncontrollable urge to move the legs, particularly during periods of rest or inactivity. The discomfort is often described as crawling, itching, aching, or pulling sensations. These symptoms tend to worsen in the evening or at night and are usually relieved by movement.
While the legs are primarily affected, in some cases, the arms may also experience similar sensations. RLS can disrupt sleep and, over time, lead to mood disturbances, chronic fatigue, and impaired focus.
Why CKD Patients Are More at Risk
Research shows that nearly one in four people with chronic kidney disease suffer from RLS, with higher prevalence among those on hemodialysis. This increased risk is largely tied to iron deficiency, which is common in CKD patients due to factors like blood loss during dialysis, poor iron absorption, and ongoing inflammation.
Brain imaging and spinal fluid analysis in people with RLS reveal low iron concentrations, particularly in areas that regulate dopamine—a chemical essential for muscle control. In kidney disease, both absolute and functional iron deficiencies are often seen. Patients tend to have reduced levels of ferritin and transferrin saturation, along with elevated total iron-binding capacity (TIBC), indicating iron imbalance that may directly contribute to RLS symptoms.
Recognising the Symptoms
The symptoms of RLS vary in intensity but commonly include:
- Discomfort after sitting or lying down for long periods
- Temporary relief through leg movement or stretching
- Trouble falling or staying asleep due to nighttime symptoms
- Involuntary leg movements during sleep
- Difficulty focusing and low mood due to sleep disruption
Causes Beyond Kidney Disease
While many RLS cases are linked to CKD and iron deficiency, other health conditions also contribute. These include diabetes, peripheral neuropathy, and neurological disorders involving dopamine pathways, such as Parkinson’s disease. Genetics also play a role, as the condition is known to run in families. In some individuals, no specific cause can be identified.
Managing RLS: Treatment and Lifestyle Support
Though there is currently no cure for RLS, various treatments can help manage symptoms. Addressing iron deficiency through supplementation, where appropriate, is often a primary focus in CKD patients. Limiting stimulants like caffeine, alcohol, and tobacco—especially in the evening—can also reduce symptom flare-ups.
Other helpful strategies include:
- Establishing a consistent and calming bedtime routine
- Taking warm baths or using heating pads and ice packs
- Trying leg massages or gentle stretching before bed
- Using devices such as vibration pads or pressure wraps for temporary relief
( Originally published on Jun 20, 2025 )
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