Utility of Adding Once-Weekly Hemoadsorption to High-Volume Hemodiafiltration for Refractory Restless Legs Syndrome: A Clinical Case Report.

Dialysis improves survival in kidney failure but does not effectively remove larger uremic toxins, contributing to persistent symptoms like restless legs syndrome (RLS). High-volume hemodiafiltration (HDF) has improved these issues, but refractory cases may require combined therapies with hemoadsorption (HA). We present a patient with refractory RLS treated with HDF plus hemoadsorption using Jafron HA130 cartridges. The β2 microglobulin (β2M) reduction ratio was higher during HDF+HA (76.4% [75.8-77.8] vs. 72.9% [71.1-73.2]), with further improvement at QB > 400 ml/min (77.6% [77.2-79.4]). Despite similar baseline β2M levels, the patient's RLS score dropped from 32 to 0 points. Adding once-weekly hemoadsorption to high-volume HDF using HA130 adsorption may enhance refractory uremic symptom management, particularly at higher QB values. Given the scarce literature on this approach, our case highlights its potential benefits for dialysis patients with persistent uremic symptoms.