Pramipexole for the treatment of uremic restless legs in patients undergoing hemodialysis

Restless legs syndrome (RLS) is common and severe in uremic patients.1 The restoration of normal kidney function by a successful transplant may resolve uremic RLS,1 but unfortunately this is not an option for all patients. Levodopa has been used with success,2 but it is associated with rebound and increased symptoms. Dopamine agonists are a useful alternative in severe RLS. Pramipexole has been found effective in controlled studies in idiopathic RLS,3 but, to our knowledge, it has not been used in uremic RLS. We describe an experience using pramipexole in uremic RLS in patients undergoing dialysis. One hundred seventy-two patients on hemodialysis were screened by two neurologists for RLS, using the criteria proposed by the International Restless Legs Syndrome Study Group.4 We recruited patients whose symptoms were severe enough to interfere with dialysis: They needed to be disconnected most of the time to …