1 3 Int Urol Nephrol DOI 10.1007/s11255-017-1573-3 NEPHROLOGY - ORIGINAL PAPER Restless legs syndrome in maintenance hemodialysis patients: an epidemiologic survey in Hefei Jian-Ping Xiao 1 · Gui-Xia Zhang 1 · Lei Chen 2 · Ben-Gui Sun 3 · Hong-Xu Zhang 4 · Li-Hong Chen 5 · Liang Yuan 1 · Li Hao 1 · De-Guang Wang 1 Received: 2 November 2016 / Accepted: 17 March 2017 © Springer Science+Business Media Dordrecht 2017 157.5), P = 0.001]. The multivariate logistic regres- sion showed that high hemoglobin level (OR 0.975, 95% CI 0.956–0.995, P = 0.015) was a protective factor for RLS, while high alkaline phosphatase (OR 1.003, 95% CI 1.001–1.005, P = 0.018) was an independent risk factor for RLS. RLS patients had significantly higher PSQI scores (P < 0.001), reduced subjective sleep quality (P < 0.001), increased sleep latency (P < 0.007), shorter sleep duration (P < 0.001), lower sleep efficiency (P = 0.001), higher sleep disturbances (P < 0.001), and increased daytime dys- function (P = 0.019). Conclusion Our findings demonstrated that the prevalence of RLS was 14.5% in Hefei. High hemoglobin level was a protective factor for RLS, and high alkaline phosphatase was an independent risk factor. RLS affects many aspects of quality of life and sleep quality, which may contribute to the presence of depression and anxiety. Keywords Restless legs syndrome · Maintenance hemodialysis · Prevalence · Hemoglobin · Alkaline phosphatase Introduction Restless legs syndrome (RLS), also called Willis–Ekbom disease, is a common sleep disorder with disturbing sensa- tions and involuntary urge to move the lower limbs, espe- cially at the night. The syndrome can be idiopathic with familial aggregation or secondary to end-stage renal dis- ease (ESRD), metabolic disorders, iron deficiency anemia, rheumatoid arthritis, Parkinson’s disease, pregnancy, thy- roid dysfunction [1–4]. A high incidence of RLS in ESRD was investigated which was called uremic restless legs syn- drome [5]. Abstract Objective To investigate the prevalence of restless legs syndrome (RLS) in maintenance hemodialysis (MHD) patients and its possible influencing factors. Methods MHD patients were consecutively enrolled from five hemodialysis centers in Hefei. Clinical, demographics, and laboratory data were recorded from December 2013 to March 2014. RLS diagnosis scale, Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS), Pittsburgh Sleep Quality Index (PSQI), and kidney disease and quality of life (KDQOLTM-36) were used for analysis. Results A total of 269 MHD patients (81 women, 188 men) were enrolled, among which 39 patients were diag- nosed as RLS. The median duration of dialysis therapy was 33 months and the prevalence of RLS was 14.5%. Compared with RLS-negative patients, RLS-positive patients had lower hemoglobin level (98.67 ± 13.50 vs 106.34 ± 17.75, P = 0.011) and higher alkaline phos- phatase concentration [131.0 (98.0, 226.0) vs 94.0 (69.8, * De-Guang Wang wangdeguang@ahmu.edu.cn 1 Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, Anhui, China 2 Department of Nephrology, First People’s Hospital of Hefei, 390 Huaihe Road, Hefei, Anhui, China 3 Department of Nephrology, The Second People’s Hospital of Hefei, 246 Heping Road, Hefei, Anhui, China 4 Department of Nephrology, The Second People’s Hospital of Anhui, 1686 Dangshan Road, Hefei, Anhui, China 5 Department of Nephrology, The Armed Police Hospital of Anhui, 78 Shangfeng Road, Hefei, Anhui, China