Restless Legs Syndrome in Dialysis Patients: Does the Dialysis Modality Influence Its Occurrence and Severity?

Menezes, Andreia Freire de; Motta, Douglas Rafanelle Moura de Santana; Carvalho, Fernanda Oliveira de; Santana–Santos, Eduesley; Júnior, Manoel Pacheco de Andrade; Figueirôa, Mirela Farias; Farias, Marta Cristina Vieira; Bastos, Kleyton de Andrade

doi:10.1155/2018/1414568

Cited by 16 publications

(18 citation statements)

References 31 publications

(40 reference statements)

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“…Apart from these general sleep quality indices, the incidence of RLS and sleep apnoea, two parameters that might be overlooked with actigraphy, were found to be different among dialysis modalities. Using the criteria from the International Restless Legs Syndrom Study Group (IRLSSG) for the diagnosis and severity of RLS, patients on automated PD presented higher RLS severity compared with the HD group [ 43 ]. And previous PSG measurements also revealed that daytime dialysis may result in more obstructive and central apnoea as compared with nocturnal PD and HD [ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

The complexity of sleep disorders in dialysis patients

Eloot

Holvoet

Dequidt

et al. 2021

Clinical Kidney Journal

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Background Dialysis patients experience a high burden of physical and emotional symptoms directly affecting their sleep and quality of life. In this study, objective and subjective measurements to quantify sleep were performed, compared with those of healthy controls, and associated with burden of comorbidity and uraemic toxicity. Methods A total of 64 dialysis patients were included—10 peritoneal dialysis, 42 in-centre daytime haemodialysis (HD) and 12 in-centre nocturnal HD patients—as well as one-to-one age- and gender-matched healthy controls. Assumed and actual sleep time, sleep efficiency and fragmentation index were measured by actigraphy for at least two consecutive nights. Patients and controls also completed Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. The patients’ blood was sampled to determine concentrations of a representative series of uraemic toxins and the Davies–Stoke comorbidity index was derived from medical records. Results Apart from the assumed sleep time, all objectively and subjectively measured sleep parameters were worse in the dialysis group compared with the healthy controls. No differences were seen in any of the measured sleep parameters among the different dialysis groups. None of the objectively measured sleep parameters were associated with ISI or PSQI scores in dialysis patients, while sleep times were related to the subjective scores in the healthy cohort. Objectively assessed sleep parameters were associated to neither the uraemic toxicity load nor the Davies–Stoke score. Conclusions Independent of the modality, dialysis patients have sleep quality much worse than age- and gender-matched healthy controls. The objectively measured sleep parameters could not be associated to the subjective score, uraemic toxicity or comorbidity score, highlighting the need for objective measurements of sleep and clinical guidelines to aid patient management.

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Section: Discussionmentioning

confidence: 99%

The complexity of sleep disorders in dialysis patients

Eloot

Holvoet

Dequidt

et al. 2021

Clinical Kidney Journal

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“…This result was similar to a study conducted by Santos et al and de Menezes where this significance was due to increase in serum parathormone or due to anemia (decreased hemoglobin) irrespective of iron status. [ 24 25 ] In another study, they have attributed this to the proinflammatory nature of dialysis as a physiological basis for patients on prolonged hemodialysis. [ 26 ]…”

Section: Discussionmentioning

confidence: 99%

Impact of different stages of chronic kidney disease on the severity of Willis–Ekbom disease

Bhagawati

Kumar

Agrawal

et al. 2019

J Family Med Prim Care

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Introduction:Willis–Ekbom disease (WED)/restless legs syndrome (RLS) is a disorder in which the patient has neurologic features such as urge of rhythmic limb movement that may decrease or stop when the limb is moved. In this study, we had tried to compare the severity of WED in different stages of chronic kidney disease (CKD).Materials and Methods:In this study, a total of 300 patients with CKD who were >18 years of age were included. All the participants were subjected to questionnaire for the diagnosis of RLS (essential clinical criteria for the diagnosis of RLS) and a questionnaire on International Restless Legs Syndrome Study Group Rating Scale for its severity.Observation and Results:Our study showed a prevalence of 20% of WED in patients with CKD. Patients with CKD on hemodialysis had significantly more WED than the conservative group (P = 0.0001). Patients with a history of diabetes mellitus showed significant correlation with WED (P = 0.026), while patients who had a history of hypertension showed both diabetes mellitus and hypertension and smoking had no significant relation with WED (P = 0.27, P = 0.23, and P = 0.22, respectively). The different stages of CKD showed significant correlation with WED (P = 0.002), with more WED among patients with stage V CKD. WED was more in patients on hemodialysis (P = 0.0001). The correlation of different stages of CKD with the severity of WED was statistically significant (P = 0.029), with WED being more severe among stage V CKD.Conclusion:WED was more prevalent among patients with CKD who are on maintenance hemodialysis and diabetes mellitus. However, no such relation could be established for hypertension alone. Patients with higher grades of CKD were more prone to have WED symptoms, and the severity of these symptoms increases with the stages of CKD.

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“…At present, more than 272,000 ESRD patients receiving peritoneal dialysis treatment worldwide, which accounts for ~11% of dialysis patients ( 1 ). Restless legs syndrome (RLS) is a neurological sensorimotor disorder and a severe complication in patients undergoing PD, with a prevalence rate of about 24.7% ( 2 ). Patients undergoing PD with RLS will feel an urge to move the legs especially during rest which will lead to having trouble falling asleep ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…RLS not only reduces the sleep quality of patients which induces daytime fatigue, poor mental health, and emotional anxiety, but also may increase the risk of hypertension, cardiovascular disease, and cerebrovascular disease ( 4 ). RLS seriously affects the quality of life and prognosis of patients undergoing PD, but still lacks effective treatment ( 2 ). It's essential to understand the pathogenesis of RLS.…”

Section: Introductionmentioning

confidence: 99%

Relation of Serum Hepcidin Levels and Restless Legs Syndrome in Patients Undergoing Peritoneal Dialysis

et al. 2021

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Introduction: Restless legs syndrome is a common and severe complication in patients undergoing peritoneal dialysis (PD), which seriously affects the life quality and prognosis of patients undergoing PD. Unfortunately, there are still no effective prevention and treatment measures. Serum hepcidin was demonstrated to be related to primary restless legs syndrome (RLS), whereas there are no studies on the relationship between serum hepcidin and RLS in patients undergoing PD. We aimed to evaluate the role and function of serum hepcidin in patients undergoing PD with RLS.Methods: A total of 51 patients undergoing PD with RLS and 102 age-and gender-matched patients undergoing PD without RLS were included. We collected the clinical data including serum hepcidin of those patients undergoing PD. We scored the severity of RLS according to the International restless leg Syndrome Research Group rating scale (IRLS). We compared the clinical characteristics of the two groups and evaluated the determinant factors of RLS by Logistic regression analysis. In addition, we evaluated the diagnostic value of serum hepcidin in patients undergoing PD with RLS by receiver operating characteristic (ROC) curve. We also analyzed the influencing factors of IRLS by multivariate linear regression analysis.Results: The duration of PD, serum hepcidin, and calcium were found to be significantly higher in patients undergoing PD with RLS than those patients undergoing PD without RLS (P < 0.001, P < 0.001, and P = 0.002, respectively). The level of hemoglobin, albumin, and RKF were significantly lower in patients undergoing PD with RLS (P = 0.002, P = 0.042, and P < 0.001, respectively). The duration of PD [odds ratio (OR) 1.038, 95% CI: 1.017, 1.060, P < 0.001], hemoglobulin level (OR 0.969, 95% CI: 0.944, 0.995, P = 0.019), calcium level (OR 9.224, 95% CI: 1.261, 67.450, P = 0.029), albumin level (OR 0.835, 95% CI: 0.757, 0.921, P < 0.001), hepcidin level (OR 1.023, 95% CI: 1.009, 1.038, P = 0.001), and RKF (OR 0.65, 95% CI: 0.495, 0.856, P = 0.002) are independent determinant factors of RLS in patients undergoing PD. Multivariate linear regression analysis revealed that, in addition to albumin, they were also independently associated with the severity of RLS.Conclusion: A significant relation was detected between serum hepcidin level and RLS in patients undergoing PD.

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Restless Legs Syndrome in Dialysis Patients: Does the Dialysis Modality Influence Its Occurrence and Severity?

Cited by 16 publications

References 31 publications

The complexity of sleep disorders in dialysis patients

The complexity of sleep disorders in dialysis patients

Impact of different stages of chronic kidney disease on the severity of Willis–Ekbom disease

Relation of Serum Hepcidin Levels and Restless Legs Syndrome in Patients Undergoing Peritoneal Dialysis

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