Abstract:

Objective To analyze the clinical characteristics and risk factors of restless legs syndrome （RLS）in maintenance hemodialysis（MHD）patients，and to evaluate the clinical efficacy of hemodiafiltration with endogenous reinfusion（HFR）in the treatment of RLS and sleep quality in MHD patients. Methods The related risk factors of RLS were investigated in the patients who had received MHD in the second affiliated hospital of Suzhou University from June 1，2020 to December 31，2020. Forty⁃nine patients with RLS were randomly divided into HFR group and hemodiafiltration（HDF）group. The changes in laboratory indexes，RLS severity and sleep quality before and 3 months after treatment were observed. Results Of 247 MHD patients，there were 49 RLS cases. Logistic regression analysis showed that dialysis duration ≥ 50 months，higher phosphorus level，lower urea removal index and higher β2 microglobulin level were the risk factors associated with RLS in HD patients（P < 0.05）. As compared with the baselines ，serum β 2 ⁃microglobulin level ，RLS scores ，and PSQI scores were decreased significantly in HFR group，but only RLS scores decreased significantly in HDF group. Level of serum β2⁃microglobulin（t = -2.122，P = 0.047）and RLS scores（t = -2.113，P = 0.048）in HFR group were lower than those in HDF group. Conclusions Longer dialysis duration，higher serum phosphorus level，lower urea clearance index，and higher β2⁃microglobulin level are the independent risk factors for RLS. HFR is more effective in improv⁃ ing sleep quality and symptoms of RLS than HDF. 

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