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Objective To investigate the incidence of restless legs syndrome (RLS) in hemodialysis patients and to analyze the related risk factors. Methods There were 220 cases of hemodialysis as hemodialysis group and 40 cases of chronic nephrosis as control group. The severity of RLS was measured by International Restless Legs Syndrome Study Group Rating Scale (IRLS). Beck Depression Inventory (BDI) was used to evaluate the status of depression, Epworth Sleepiness Scale (ESS) was used to evaluate excessive daytime sleepiness (EDS), and Insomnia Severity Index (ISI) was used to evaluate the status of insomnia. Univariate and multivariate forward Logistic regression analysis was used to analyze the related risk factors for RLS in hemodialysis patients. Results In hemodialysis group duration (Z =-9.837, P = 0.000), serum ferritin (t = 2.847, P = 0.005), incidence rate of RLS (χ2 = 10.918, P = 0.001), the proportion of using hypnotic drugs (χ2 = 7.669, P = 0.006), IRLS (t = 2.322, P = 0.020) and ISI (Z = 4.117, P = 0.001) were significantly higher than control group. Univariate and multivariate forward Logistic regression analysis showed diabetes (OR = 3.387, 95% CI: 1.538-7.461; P = 0.002), BDI > 9 score (OR = 2.643, 95% CI: 1.457-4.795; P = 0.001) and ISI > 7 score (OR = 3.542, 95%CI: 1.939-6.468; P = 0.000) were independent risk factors for RLS in hemodialysis patients. Conclusions Hemodialysis patients have a high incidence of RLS and insomnia. RLS is closely related with insomnia. Depression plays an important role therein. DOI: 10.3969/j.issn.1672-6731.2018.01.009