Restless Leg Syndrome in CKD Patients Strongly Linked to Iron Deficiency, reveals study
Researchers have discovered that Restless Leg Syndrome (RLS), a painful neurological disorder characterized by an irresistible craving for movement of the legs, is far more prevalent among patients with chronic kidney disease (CKD), especially those who are on dialysis. The research, carried out at Madras Medical College, Chennai, showed that iron deficiency is a significant etiology of RLS in these patients, even with normal ferritin levels, suggesting functional iron deficiency. The results underscore the importance of early detection and specific iron therapy to control the symptoms and enhance quality of life. The study was published in Cureus journal by Parimala E. and colleagues.
The present study was a cross-sectional observational study that was conducted over a period of six months on 150 adult patients suffering from Stage 3 to Stage 5 CKD. Participants were divided into four treatment groups: those on hemodialysis (HD), peritoneal dialysis (PD), conservative management (non-dialysis), and post-renal transplant patients. Exclusion criteria included any history of non-CKD neurological or psychiatric disorders, or use of medications known to cause RLS.
The diagnosis of RLS was confirmed using the standardized criteria of the International Restless Legs Syndrome Study Group (IRLSSG). Clinical interviews, case record review, and detailed laboratory tests — including iron tests like serum ferritin, transferrin saturation (TSAT), serum iron, and total iron-binding capacity (TIBC), were employed for data collection. SPSS software was used for statistical analysis, and a p-value below 0.05 was considered significant.
Key Findings
The participants' mean age was 51.6 years (±12.3) and 58% were male.
The distribution of treatment modalities revealed that 40% of patients were on hemodialysis, 28% were conservatively managed, 18% were on peritoneal dialysis, and 14% were transplant recipients.
In total, 42% of patients were diagnosed with RLS (63 out of 150).
The highest prevalence was in the hemodialysis group (51.7%), followed by the peritoneal dialysis group (40.7%), conservative treatment group (26.2%), and transplant group (23.8%).
Older patients over the age of 60 and women presented with a greater frequency of RLS (46.7% and 47.6%, respectively).
Moreover, RLS was more frequent in diabetic patients (47.8%) compared to non-diabetics (37%).
RLS patients were found to have significantly lower levels of iron on various parameters.
The average serum ferritin was 88.4 ng/mL in RLS patients, whereas it was 126.7 ng/mL in non-RLS patients.
Transferrin saturation (TSAT) was 16.3% in RLS and 22.1% in non-RLS patients.
The serum iron concentration was 48.2 µg/dL in RLS, which was statistically lower than 64.7 µg/dL in non-RLS.
Conversely, TIBC levels were elevated at 295 µg/dL in RLS as opposed to 273 µg/dL in the non-RLS group.
All the differences were statistically relevant with p-values below 0.01.
This research supports the fact that movement disorder Restless Leg Syndrome is quite common among CKD patients, particularly those undergoing dialysis, and has a close relationship with iron deficiency. These results imply that early identification and management of iron deficiency, including functional iron deficiency, are necessary to counteract RLS symptoms and enhance the quality of life in CKD patients.
Reference:
Elangovan P, Murugadhandayuthapany A, S D, et al. (June 17, 2025) Prevalence of Restless Leg Syndrome and Its Association With Iron Deficiency in Patients With Chronic Kidney Disease: A Cross-Sectional Observational Study. Cureus 17(6): e86188. doi:10.7759/cureus.86188
