SynthesisFrontiers in neurology
Efficacy and safety of pharmacological treatments for restless legs syndrome in hemodialysis patients: a systematic review and meta-analysis.
Synthesis in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Background: Restless Legs Syndrome (RLS) is highly prevalent among adults receiving maintenance hemodialysis and significantly impairs sleep, psychological well-being, and quality of life. While Western pharmacological treatments such as dopaminergic agents, gabapentinoids, and iron therapy are commonly studied, Traditional Chinese Medicine (TCM) is also widely used in clinical practice-particularly for syndromes corresponding to RLS such as Methods: A comprehensive search of PubMed, EMBASE, CENTRAL, Scopus, Web of Science, ClinicalTrials.gov, and Chinese-language databases was conducted from inception to January 2025. Eligible studies included randomized, quasi-experimental, and observational studies of pharmacologic therapies-Western medications or TCM-derived pharmaceutical preparations-administered for RLS in adults on hemodialysis. The primary outcome was change in International Restless Legs Scale (IRLS) scores; secondary outcomes included sleep quality, quality of life, dialysis adequacy, and adverse events. Random-effects meta-analyses, subgroup analyses, and GRADE assessments were performed. Results: Sixteen studies ( Conclusion: Western pharmacologic agents-particularly gabapentinoids-are effective for managing RLS in hemodialysis patients. Dopaminergic agents are beneficial but limited by higher adverse event risks, while iron therapy offers moderate benefits with good tolerability. Although TCM is widely used for symptom patterns associated with RLS and shows theoretical promise, high-quality, hemodialysis-specific pharmacologic TCM trials are lacking. To support integrated Chinese-Western clinical practice, rigorous future RCTs of standardized TCM formulations are urgently needed. This study provides evidence to guide clinical decision-making and emphasizes the importance of individualizing treatment approaches to balance efficacy and safety for patients undergoing hemodialysis.
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