Lansoprazole may trigger or exacerbate restless legs syndrome and periodic limb movement disorder in hemodialysis patients
A 76-year-old hemodialysis patient developed dopaminergic-refractory RLS/PLMD after starting lansoprazole 15 mg/day. Symptoms nearly completely resolved within 14 days of lansoprazole withdrawal, with RLS-6 score dropping from 28 to 4, and a Naranjo score of 5 indicating a probable adverse drug reaction.
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Lansoprazole may trigger or exacerbate restless legs syndrome and periodic limb movement disorder in hemodialysis patients The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 34/100 (low).
The Claim
Lansoprazole may trigger or exacerbate restless legs syndrome and periodic limb movement disorder in hemodialysis patients
This conclusion is most relevant to: A 76-year-old female hemodialysis patient with end-stage renal disease due to diabetic nephropathy.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Lansoprazole as a possible trigger of restless legs syndrome with suspected periodic limb movement disorder in a hemodialysis patient: a case report. (CEN case reports, 2026) —
How It Works
The proposed biological pathway:
- ▸Lansoprazole may alter iron absorption or metabolism in susceptible patients
- ▸Iron deficiency or dysregulation can affect dopaminergic function
- ▸Dopaminergic dysfunction contributes to RLS/PLMD pathophysiology
- ▸Result: Lansoprazole withdrawal leads to symptom improvement
Who Might Benefit
Evidence fit by population:
- ▸A 76-year-old female hemodialysis patient with end-stage renal disease due to diabetic nephropathy
Recommended Dose
15 mg/day
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Single case report with no control group, limiting generalizability
- ▸Confounding from prior discontinuation of methyldopa, which may have contributed partial improvement
Frequently Asked Questions
What is the Naranjo score and what does a score of 5 mean?▼
The Naranjo scale assesses the probability of an adverse drug reaction. A score of 5 indicates a 'probable' adverse drug reaction.
Why might lansoprazole trigger RLS in hemodialysis patients?▼
PPIs like lansoprazole can impair iron absorption, and iron deficiency is a known trigger for RLS. Hemodialysis patients are already at risk for iron deficiency.
How quickly did symptoms improve after stopping lansoprazole?▼
Symptoms showed near-complete resolution within 14 days of lansoprazole withdrawal.
Is this effect specific to lansoprazole or all PPIs?▼
This case specifically implicates lansoprazole, but the authors suggest clinicians should reassess PPI necessity in general for atypical or refractory RLS/PLMD.
References
- 1.Nakata H, Nishiwaki K. “Lansoprazole as a possible trigger of restless legs syndrome with suspected periodic limb movement disorder in a hemodialysis patient: a case report..” CEN case reports, 2026. PMID: 41999568 DOI: 10.1007/s13730-026-01099-1