Restless legs syndrome in end-stage renal disease: Clinical characteristics and associated comorbidities

Araújo, Sônia Maria Holanda Almeida; Bruin, Veralice Meireles Sales de; Nepomuceno, Lucas; Maximo, Marcos Lelio; Daher, Elizabeth De Francesco; Férrer, Débora Praciano Correia; Bruin, Pedro Felipe Carvalhedo de

doi:10.1016/j.sleep.2010.02.011

Cited by 116 publications

(85 citation statements)

References 55 publications

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“…[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: 95%

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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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Section: Methodsmentioning

confidence: 95%

“…Publication bias may be another reason for this contradiction. Survival studies, all positive, seem to be very scarce [12,13,15] among epidemiological surveys on RLS in HD patients [11,14,[27][28][29][30][31][32][33][34][35][36].…”

Section: Page 12 Of 35mentioning

confidence: 99%

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

et al. 2015

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“…The frequency of RLS in AR group was higher than two folds when compared to the control group; however, the difference was not statistically significant. Restless legs syndrome severity score was significantly higher in AR group than control group (15.00 [11][12][13][14][15][16][17][18][19][20] and 11.00 [10][11][12][13][14][15][16] respectively, p=0.046). Total PSQI scores were similar between groups.…”

Section: Methodsmentioning

confidence: 99%

“…The pathophysiology of RLS is focused on the dopaminergic system, reduced central nervous system iron and genetic linkages. [8][9][10][11][12] Relationship between RLS and comorbid diseases such as iron deficiency, chronic renal failure and hyperactivity has been shown in pediatric age. [12][13][14][15] Allergic rhinitis is found to be one of the most common reasons for sleep disorders in childhood.…”

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confidence: 99%

Restless legs syndrome in children with allergic rhinitis: A comparative study on frequency, severity and sleep quality

Filiz¹

2018

Turk J Phys Med Rehab

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Objectives: This study aims to investigate the frequency and severity of restless legs syndrome (RLS) and its relationship with sleep quality in children with allergic rhinitis (AR) with the hypothesis that comorbid RLS may be an additional causative factor of sleep disturbances in pediatric AR. Patients and methods:A total of 143 children with AR (aged 8-18 years) and 144 healthy control subjects (aged 8-18 years) were included. The diagnosis of AR was established on history, clinical examination and skin prick test according to the Allergic Rhinitis and its Impact on Asthma guidelines. Presence of RLS was determined using the International RLS study group (IRLSSG) criteria. The severity of RLS was assessed using the IRLSSG rating scale. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI).Results: Thirteen patients (9.1%) in AR group, and six children (4.2%) in control group had RLS (p=0.159). The frequency of RLS in AR group was higher than two folds when compared to the control group; however, the difference was not statistically significant. Restless legs syndrome severity score was significantly higher in AR group than control group (15.00 [11][12][13][14][15][16][17][18][19][20] and 11.00 [10][11][12][13][14][15][16] respectively, p=0.046). Total PSQI scores were similar between groups. Also, no significant differences were observed in total PSQI scores of AR patients with or without RLS. Conclusion:Restless legs syndrome was not more common but was more severe in children with AR. There was no evidence that RLS has an obvious effect on sleep quality in children with AR.

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“…In chronic renal failure, WED is more common than in normal subjects [53]. Most likely, this fact is conditioned by two relatively common complications of chronic kidney failure: 1) uremic neuropathy [54]; and 2) decreased activity of the cytochrome P450 superfamily of enzymes [55,56].…”

Section: Class Of Drugsmentioning

confidence: 99%

Willis-Ekbomdisease (Restless Legs Syndrome) Pathophysiology: The Imbalance Between Dopamine and Thyroid Hormone Theory

Pereira¹,

Pradella-Hallinan²

2013

J Sleep Disorders Ther

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Willis-Ekbom disease (WED), also known as restless legs syndrome, is generally accepted as a disease of unknown pathophysiology, though it is believed that dysfunctions in the dopaminergic system and iron metabolism may play a role. However, an increasing body of evidence points to the insufficient modulation of thyrotropin hormone by the neurohormone dopamine (DA) as the underlying mechanism of the disease pathology. Additionally, it has generally been accepted that the annoying symptoms of the disease are generated inside the Blood Brain Barrier (BBB). This assumption, which has little evidence supporting it, has been weakened by the recent observation that domperidone, a DA blocking agent that does not cross the BBB, worsens the severity of WED symptoms. In 1974, it was discovered that levodopa dramatically relieves WED symptoms, thus supporting the hypothesis that insufficient dopaminergic function contributes to WED pathogenesis. Earlier, in 1970, it was observed that venous infusion of DA diminishes thyrotropin levels, and from clinical studies, it is known that WED symptoms are worse in the evening and night, when thyrotropin activity increases. Furthermore, drugs that alleviate WED symptoms increase the DA activity or decrease the Thyroid Hormone (TH) activity, whereas drugs that worsen WED tend to have the opposite effects on DA and TH activity. In this article, we present robust evidence to support the hypothesis that WED is caused by an imbalance between DA and TH and that its symptoms are generated in the periphery of the somatosensory system. We theorize that WED should be considered a functional peripheral neuropathy.

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Restless legs syndrome in end-stage renal disease: Clinical characteristics and associated comorbidities

Cited by 116 publications

References 55 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

Restless legs syndrome in children with allergic rhinitis: A comparative study on frequency, severity and sleep quality

Willis-Ekbomdisease (Restless Legs Syndrome) Pathophysiology: The Imbalance Between Dopamine and Thyroid Hormone Theory

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