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Review
. 2017 Jan;69(1):117-128.
doi: 10.1053/j.ajkd.2016.07.031. Epub 2016 Sep 29.

Sleep Disorders, Restless Legs Syndrome, and Uremic Pruritus: Diagnosis and Treatment of Common Symptoms in Dialysis Patients

Jennifer S Scherer  1 , Sara A Combs  2 , Frank Brennan  3
Affiliations
Review

Sleep Disorders, Restless Legs Syndrome, and Uremic Pruritus: Diagnosis and Treatment of Common Symptoms in Dialysis Patients

Jennifer S Scherer et al. Am J Kidney Dis. 2017 Jan.

Abstract

Maintenance dialysis patients experience a high burden of physical and emotional symptoms that directly affect their quality of life and health care utilization. In this review, we specifically highlight common troublesome symptoms affecting dialysis patients: insomnia, restless legs syndrome, and uremic pruritus. Epidemiology, pathophysiology, and evidence-based current treatment are reviewed with the goal of providing a guide for diagnosis and treatment. Finally, we identify multiple additional areas of further study needed to improve symptom management in dialysis patients.

Keywords: Sleep disorders; chronic renal failure; dialysis; end-stage renal disease (ESRD); insomnia; kidney disease; quality of life (QoL); restless legs syndrome; review; symptom management; symptoms; uremic pruritus.

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Figures

Figure 1
Figure 1
Approach to diagnosis and management of restless legs syndrome (RLS). *Drugs should be used with careful monitoring for signs of augmentation, as described in text. Drug treatment recommendations based on Molnar et al.
Figure 2
Figure 2
Management of pruritus in patients with chronic kidney disease.–,–,,–,, BUN, blood urea nitrogen; GFR, glomerular filtration rate; PTH, parathyroid hormone; UP, uremic pruritus.
See this image and copyright information in PMC

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