Prevalence, Severity, and Determinants of Restless Legs Syndrome Among Patients on Maintenance Hemodialysis: A Cross-Sectional Study

Background: Restless Legs Syndrome is a frequent neurological disorder in patients receiving hemodialysis. It causes sleep disturbance, fatigue, and reduced quality of life, yet data on its occurrence in Iraq are scarce. Aim of study: To determine the prevalence, severity, and associated factors of Restless Legs Syndrome among individuals undergoing chronic hemodialysis. Methods: A cross-sectional study was carried out from February to October 2025 in two hemodialysis centers in the Kurdistan Region of Iraq. Adult patients who had been on regular hemodialysis for at least three months were included, while those with neurological diseases or taking drugs known to trigger Restless Legs Syndrome were excluded. Diagnosis and assessment of severity followed the criteria of the 2014 International Restless Legs Syndrome Study Group. Demographic and clinical variables such as age, sex, body mass index, duration and adequacy of dialysis, and causes of kidney failure were analyzed. Results: Among 163 participants, 28.2 % had Restless Legs Syndrome (mean age 50.1 ± 14.2 years; 55.2 %female). The condition was more common in women, obese patients, those with dialysis duration exceeding five years, and those with inadequate dialysis. No association was found with age, frequency of dialysis, or cause of kidney disease. Of the affected patients, 11 % had very severe and 59% had moderate to severe symptoms. Conclusion: Restless Legs Syndrome is common among hemodialysis patients, particularly women, obese individuals, and those with prolonged or insufficient dialysis. Early screening and management of risk factors may improve outcomes.