Restless legs symptoms among incident dialysis patients: Association with lower quality of life and shorter survival

Unruh, Mark; Levey, Andrew S.; D’Ambrosio, Carolyn; Fink, Nancy E.; Powe, Neil R.; Meyer, Klemens B.

doi:10.1053/j.ajkd.2004.01.013

Cited by 190 publications

(167 citation statements)

References 41 publications

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“…Similarly, in contrast to previous surveys [13], in our study there was no observed association between mortality of HD patients and severity of RLS.…”

Section: Page 12 Of 35contrasting

confidence: 56%

“…(2004) also reported an association of severe RLS with mortality [13]. The number of patients analyzed was quite limited in these reports [12,15], and lack of power might be a plausible explanation for the conflicting findings between the present and previous reports of mortality in uremic RLS.…”

Section: Page 12 Of 35contrasting

confidence: 52%

“…Uremic RLS has been frequently associated with increased morbidity and enhanced mortality in patients with end-stage renal disease [12][13][14][15]. In the general population, however, studies of this association have reported inconsistent results.…”

Section: Introductionmentioning

confidence: 81%

“…[11,19,20]. According to the IRLSSG rating scale, severity was classified as mild (<11 on the IRLSSG rating scale), moderate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), severe (21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and very severe (31)(32)(33)(34)(35)(36)(37)(38)(39)(40) [21]. The Page 6 of 35 prevalence of RLS found in that study was 26.6% (154/579).…”

Section: Methodsmentioning

confidence: 99%

“…Only a few studies have reported an association between the presence and/or severity of uremic RLS and high mortality rates [12][13][14][15]. In particular, increased severity of uremic RLS has been associated with an increased incidence of cardiovascular events as well as with a higher mortality rate in patients treated with HD [15] or with a kidney transplant [14].…”

Section: Page 12 Of 35mentioning

confidence: 99%

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Restless legs syndrome does not affect 3-year mortality in hemodialysis patients

et al. 2015

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Original Highlights of the studyWe evaluated the relationship of RLS and mortality in chronic hemodialysis patients For the diagnosis of RLS we implemented standard methodology, i.e. the essential clinical criteria of the International RLS Study Group. This is the first time this issue is investigated in an epidemiological survey in Greece.In contrast to previous reports the diagnosis of RLS does not influence the 3-year mortality in HD patients. ABSTRACTObjective: In chronic hemodialysis (HD) patients, the prevalence of restless legs syndrome (RLS) is significantly higher than in the general population. Uremic RLS has been related to an enhanced mortality of HD patients. In the general population, however, studies of this association have yielded inconsistent results. The aim of the present study was to re-evaluate the relationship of RLS and mortality in HD patients. Methods:We recorded the 3-year mortality rate in a population of 579 HD patients after assessment for RLS symptoms. In addition we analyzed the 5-year mortality rate after end-stage renal disease onset (i.e., commencement of HD). This HD patient population has been previously included in a cross-sectional survey of RLS prevalence in which RLS diagnosis was based on the essential clinical criteria of the International RLS Study Group. Mortality data were acquired from the national endstage renal disease registry. Survival probability was calculated by means of the Kaplan-Meier method and analyzed by the log-rank (Mantel-Cox) test. For multivariate survival analysis, we implemented a proportional hazards regression Conclusion: Diagnosis of RLS according to the essential clinical criteria of theInternational RLS Study Group does not seem to influence the 3-year mortality in HD patients. Our findings are in contrast to those in some previous reports, and reinforce the need for further studies of RLS and mortality in HD patients.

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“…Similarly, in contrast to previous surveys [13], in our study there was no observed association between mortality of HD patients and severity of RLS.…”

Section: Page 12 Of 35contrasting

confidence: 56%

Section: Page 12 Of 35contrasting

confidence: 52%

Section: Introductionmentioning

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Section: Page 12 Of 35mentioning

confidence: 99%

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Restless legs syndrome does not affect 3-year mortality in hemodialysis patients

et al. 2015

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Peritoneal dialysis versus haemodialysis for people commencing dialysis

Ethier,

Hayat,

Pei

et al. 2024

Cochrane Database of Systematic Reviews

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Clinical significance of RLS

et al. 2007

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While the restless legs syndrome (RLS) may have been known in antiquity, it has only recently come to medical attention. Individuals with RLS fall along a spectrum from mild, infrequent symptoms to those with severe daily life-impairing discomforts and sleep disruption. These problems can cause impaired mood, daytime fatigue, cognitive difficulties, and inability to participate in a variety of quiet activities. This leads to a general reduction in quality of life similar to other significant psychiatric and medical disorders. Recent studies suggest that RLS may be a risk factor for developing both psychiatric disorders (such as major depression and anxiety) and somatic diseases (such as hypertension and cardiovascular disease). In dialysis patients, RLS has been found to be a risk factor for mortality. Therefore, those with RLS who have clinically significant symptoms suffer increased morbidity and are at risk for impaired long-term medical outcomes.

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Restless legs symptoms among incident dialysis patients: Association with lower quality of life and shorter survival

Cited by 190 publications

References 41 publications

Restless legs syndrome does not affect 3-year mortality in hemodialysis patients

Restless legs syndrome does not affect 3-year mortality in hemodialysis patients

Peritoneal dialysis versus haemodialysis for people commencing dialysis

Clinical significance of RLS

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