Restless Legs Syndrome: Associated Risk Factors in Hemodialysis Patients

Abstract

Background:Restless legs syndrome (RLS) may be associated with increased morbidity and mortality among end-stage renal disease (ESRD) patients; however, it is a disorder that is neglected in dialysis centers.Objectives:The goal of this study was to investigate the clinical factors associated with RLS among ESRD patients.Patients and Methods:This cross-sectional study was conducted on ESRD patients undergoing maintenance hemodialysis (HD) in three HD centers in Ahvaz city in Southwest Iran. Blood samples were obtained prior to a dialysis session to check the routine laboratory test results and assess the adequacy of dialysis. The presence of RLS was assessed by using the international RLS study group (IRLSSG) diagnostic criteria. The IRLSSG rating scale was also used to evaluate the severity of the RLS symptoms.Results:Of the 139 HD patients enrolled in this study, 60 were female (43.2%) and 79 were male (56.8%), with a mean age of 51.82 ± 13.31 years. The prevalence of RLS was 15.8% (22 patients), with 50% of them (11 patients) having severe or very severe symptoms. There was a significant relationship between RLS and longer durations of dialysis (P < 0.001). The mean level of serum ferritin was lower in patients without RLS, but it was not significant (P = 0.065). No significant differences were found according to age, gender, dialysis shifts, and hemoglobin (Hb) level among patients with and without RLS.Conclusions:We conclude that a significant percentage of ESRD patients undergoing maintenance HD have severe or very severe RLS symptoms. The presence of RLS is associated to longer durations of dialysis.

Pengaruh Latihan Kekuatan terhadap Restless Legs Syndrome Pasien Hemodialisis

“…Hal ini dapat menguatkan semakin lamanya durasi hemodialisis dapat memperburuk keadaan RLS. Beladi-Mousavi et al (2015) menemukan hubungan antara durasi dialisis dan munculnya RLS. Hubungan ini dikaitkan dengan risiko berkembangnya RLS.…”

Exploring sleep disorders in patients with chronic kidney disease

“… 99 – 102 Because iron is bound to hemoglobin, a decrease in the count of red blood cells leads to a decrease in hemoglobin levels thereby causing a decrease in the levels of iron. 100 Low levels of iron have been implicated as the primary cause of RLS and is directly linked to CKD and dialysis. 8 , 16 A measurement of serum ferritin provides a definitive diagnosis as it relates to the levels of serum iron and has been implicated in anemia in case of chronic disease.…”

The effects of vibration and massage on severity of symptoms of restless leg syndrome and sleep quality in hemodialysis patients; a randomized cross-over clinical trial

“…The end-stage of renal failure involves the irreversible and progressive reduction of kidney function which requires alternative treatment for kidney function (1). Currently, the most common treatment modality for pronounced renal failure around the world is hemodialysis (2).…”

“…RLS is one of the common complications among ESRD patients (5). It is a neurologic sensory-motor impairment (6) which is described as an unpleasant feeling in the feet occurring as a result of inclination for moving the lower extremities and relieves with movement (1). In the case of aggravation of symptoms, this condition can involve the arms and other parts of the body (7).…”

“…In the case of aggravation of symptoms, this condition can involve the arms and other parts of the body (7). These symptoms are usually manifested at night or at rest leading to sleep disturbances (1). On the basis of international standards of RLS, the diagnostic criteria of this syndrome are as follows: 1) Sensory symptoms in the feet leading to frequent uncontrollable movements in the feet, 2) Onset or deterioration of symptoms at rest, 3) Improvement or relief of symptoms at rest, and 4) Aggravation of symptoms in the evening or at night.…”