Abstract
Pain from a number of causes is the most common problem affecting hemodialysis (HD) patients. This population also has a high prevalence of restless legs syndrome (RLS). We report on a woman in her seventies undergoing HD with severe back pain and RLS. She had been treated with oral pramipexole since developing RLS about 2 years previously. After that, she suffered from severe back pain, and opioid buprenorphine transdermal patch was prescribed for 7 months. Recently, the buprenorphine use was discontinued according to her wishes. RLS symptoms were provoked within a few days, and became severe enough to disturb her HD therapy with time. Readministration of the buprenorphine patch rapidly relieved her symptoms, so the exacerbation was considered to have been associated with the withdrawal of buprenorphine. As subsequent discontinuation could be difficult, it would be prudent to select opioid analgesics for chronic pain in HD patients with RLS.
