Evidence map›Paper›PMID 40269733›Full record

ArticleBMC nephrology2025

Treatment of insomnia, restless legs, cramps, and pain associated with chronic kidney disease: results from a multinational survey of kidney supportive care practice.

Kurinji Nalankilli, Elizabeth Stallworthy, Kathryn Ducharlet, Barnaby D Hole, Daniel V O'Hara, Neeru Agarwal, Charlotte M Snead, Fergus J Caskey, Brendan Smyth

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kurinji NalankilliRenal Department, Waikato Hospital, Hamilton, New Zealand.
Elizabeth StallworthyDepartment of Renal Medicine, Auckland City Hospital, Auckland, New Zealand.
Kathryn DucharletDepartment of Renal Medicine, Eastern Health, Box Hill, Australia.
Barnaby D HolePopulation Health Sciences, University of Bristol, Bristol, UK.
Daniel V O'HaraNHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia.
Neeru AgarwalNHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia.
Charlotte M SneadPopulation Health Sciences, University of Bristol, Bristol, UK.
Fergus J CaskeyPopulation Health Sciences, University of Bristol, Bristol, UK.
Brendan SmythNHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia. brendan.smyth@sydney.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKidney failure is associated with a high symptom burden, yet few studies describe real-world management approaches.

methodsKidney care units in Australia, New Zealand (NZ) and the United Kingdom (UK) were surveyed regarding their pharmacological treatment of a range of common symptoms affecting those with kidney failure. The present report describes the results for insomnia, restless legs syndrome (RLS), cramps, and pain. Variation in responses was described using normalised generalised variance (NGV), resulting in a score from 1 (most diverse) to 0 (least diverse).

resultsOne hundred and twelve (of 171 contacted) kidney units responded, including 56 units in Australia (50%), 7 in NZ (6%), and 49 in the UK (44%). Diversity of practice was highest for insomnia (mean NGV 0.95, range 0.93-0.98), where melatonin was the leading first-line agent (38%), followed by zolpidem and zopiclone (29%). Diversity of practice was lowest for RLS (mean NGV 0.66, range 0.30-0.99), owing to widespread use of iron replacement as first line (69%), gabapentinoids (45%), and dopamine agonists (37%). Diversity of practice was moderate for neuropathic pain (mean NGV 0.71, range 0.44-0.93), cramps (mean NGV 0.72, range 0.48-0.97), and opioids (mean NGV 0.88, range 0.75-0.97). Numerous significant between-country differences in treatment preferences were noted.

conclusionsThere is wide variation in treatment approaches to common symptoms affecting people living with advanced CKD or kidney failure, both within and between countries, indicating a need for evidence-based guidelines and further randomised studies to inform practice. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Muscle CrampPain ManagementRenal Insufficiency, ChronicRestless Legs SyndromeSleep Initiation and Maintenance DisordersAustraliaHumansNew ZealandSurveys and QuestionnairesUnited KingdomChronic kidney diseaseCrampsInsomniaKidney supportive carePainRestless legs

Identifiers

PMID40269733
PMCPMC12016115

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.