The association between iron deficiency anemia and restless leg syndrome in dialysis-dependent patients.

Abstract

Objective: To evaluate the association between iron deficiency anemia (IDA) and restless leg syndrome (RLS) in dialysis-dependent patients. Study Design: Descriptive Cross-sectional study. Setting: Department of Nephrology, Khyber Teaching Hospital, Peshawar. Period: 16th July to 30^th October 2025. Methods: A total of 108 patients undergoing maintenance hemodialysis for at least three months were included. Demographic, clinical, and laboratory parameters were recorded. IDA was defined as serum ferritin <100 ng/mL with transferrin saturation <20%. RLS was diagnosed using the International Restless Legs Syndrome Study Group (IRLSSG) criteria. Statistical analysis was performed using SPSS version 26. Chi-square and independent t-tests were applied, with p ≤ 0.05 considered significant. Results: The mean age was 49.8 ± 13.2 years, with a male predominance (58.3%). IDA was present in 59.3% of patients, and overall RLS prevalence was 41.7%. Patients with IDA had a significantly higher occurrence of RLS compared to those without IDA (62.5% vs. 13.6%, p < 0.001). Mean hemoglobin and ferritin levels were lower in the RLS group (p < 0.01). Additionally, lower serum albumin and longer dialysis duration were independently associated with increased RLS prevalence. Conclusion: IDA is strongly associated with RLS in dialysis-dependent patients, and hypoalbuminemia may further increase risk. Early identification and management of IDA and nutritional deficits may improve patient outcomes.