Restless legs syndrome in end-stage renal disease patients undergoing hemodialysis

Castillo-Torres, Sergio Andrés; Ibarra-Sifuentes, Héctor Raúl; Sánchez-Terán, Helda; Sánchez-Martínez, Concepción; Chávez-Luévanos, Beatriz; Estrada-Bellmann, Ingrid

doi:10.1590/0004-282X20180133

Acessibilidade / Reportar erro

Brasil

Arquivos de Neuro-Psiquiatria

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Article • Arq. Neuro-Psiquiatr. 76 (12) • Dec 2018 • https://doi.org/10.1590/0004-282X20180133 copy

Restless legs syndrome in end-stage renal disease patients undergoing hemodialysis

Síndrome de Piernas Inquietas en enfermedad renal crónica terminal en hemodiálisis

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Restless legs syndrome (RLS) is a frequent complication of hemodialysis that has been associated with poor quality of life and increased risk for complications. Nevertheless, few studies regarding this entity exist in resource-limited settings.

Objectives:

To determine the prevalence of RLS among Mexican patients on hemodialysis; and compare these patients with a control group of the same population.

Methods:

We recruited 105 hemodialysis patients. Restless legs syndrome was diagnosed according to the updated criteria set out by the International RLS Study Group. We selected patients who did not meet the criteria, as controls.

Results:

We found an RLS prevalence of 18%. The RLS patients had a significantly higher prevalence of iron deficiency anemia and uremic pruritus. None of the patients reported RLS symptoms prior to hemodialysis initiation.

Conclusions:

Restless legs syndrome is common among Mexican patients on hemodialysis. Larger studies are required to address the impact of RLS in hemodialysis patients.

Keywords:
Restless legs syndrome; renal dialysis; renal insufficiency

Variable	RLS	Controls	p-value^* * significant difference at .05 level;
Number of participants	19	86	na
Age (years).	45.5 ± 17.1	50.2 ± 16.0	0.253^a a p-value: calculated using the Chi square test;
Female sex - no. (%)	11 (57.9%)	47 (54.7%)	0.797^b b p-value: calculated using t test;
Hypertension - no. (%)	18 (97.4%)	77 (89.5%)	0.485 ^a a p-value: calculated using the Chi square test;
Diabetes mellitus - no. (%)	11 (57.9%)	48 (55.8%)	0.869 ^a a p-value: calculated using the Chi square test;
Iron-deficiency anemia - no. (%)	12 (63.2%)	32 (372%)	0.038 ^a a p-value: calculated using the Chi square test;
Peripheral neuropathy - no. (%)	2 (10.5%)	6 (7.0%)	0.598 ^a a p-value: calculated using the Chi square test;
Cerebrovascular disease - no. (%)	2 (10.5%)	4 (4.7%)	0.318 ^a a p-value: calculated using the Chi square test;
Duration of end-stage renal disease (years)	2.5 (0.04-9.0)	2.0 (0.2 – 25.0)	0.980^c c p-value: calculated using the Mann-Whitney U test.
Duration of undergoing hemodialysis (years)	2.0 (0.04-7.0)	1.65 (0.04 – 13.0)	0.851 ^c c p-value: calculated using the Mann-Whitney U test.
Number of hemodialysis sessions per week - no. (%)	2.0 (1.0-3.0)	2.0 (1.0 – 4.0)	0.541 ^c c p-value: calculated using the Mann-Whitney U test.
Total number of hemodialysis sessions - no.	129 (5-397)	93 (7 – 483)	0.573 ^c c p-value: calculated using the Mann-Whitney U test.
Type of access: intravenous catheter. - no. (%)	19 (100%)	76 (91.6%)	0.167 ^a a p-value: calculated using the Chi square test;
Uremic pruritus - no. (%)	8 (42.1%)	17 (20.5%)	0.039 ^a a p-value: calculated using the Chi square test;

Variable	RLS	Controls	p-value^* * Significant difference at .05 level; RLS: restless legs syndrome; eGFR-MDRD4: estimated glomerular filtration rate calculated with MDRD 4 element formula;
Number of participants	19	86	na
Hemoglobin (g/dL)	7.91 ± 1.38	8.79 ± 1.89	0.064^a a p-value: calculated using t test;
Hematocrit (%)	24.8 ± 4.3	27.7 ± 5.9	0.055^a a p-value: calculated using t test;
Mean corpuscular volume (fL)	90.3 ± 7.4	91.3 ± 6.0	0.537^a a p-value: calculated using t test;
Mean hemoglobin concentration (pg)	28.9 ± 2.8	28.9 ± 2.1	0.999^a a p-value: calculated using t test;
Platelet count (cell/mm³)	189,837 ± 68,866	193,764 ± 75,257	0.819^b b p-value: calculated using the Mann-Whitney U test.
Mean platelet volume (fL)	7.12 ± 1.38	6.80 ± 1.40	0.341^b b p-value: calculated using the Mann-Whitney U test.
Blood urea nitrogen (mg/dL)	53.6 ± 27.3	61.5 ± 26.8	0.246^a a p-value: calculated using t test;
Serum creatinine (mg/dL)	9.7 ± 3.6	9.0 ± 3.7	0.462^a a p-value: calculated using t test;
eGFR-MDRD-4 (mL/min/1.73m2)	7.3 ± 3.2	8.3 ± 6.8	0.821^b b p-value: calculated using the Mann-Whitney U test.
Sodium (mmol/L)	137.1 ± 2.9	137.3 ± 4.0	0.848^a a p-value: calculated using t test;
Potassium (mmol/L)	5.0 ± 0.9	5.3 ± 1.0	0.398^b b p-value: calculated using the Mann-Whitney U test.
Chloride (mmol/L)	101.9 ± 4.8	101.7 ± 4.6	0.886^a a p-value: calculated using t test;
Magnesium (mg/dL)	2.7 ± 0.4	2.8 ± 0.6	0.288^b b p-value: calculated using the Mann-Whitney U test.
Phosphorus (mg/dL)	5.1 ± 1.5	5.1 ± 1.7	0.987^a a p-value: calculated using t test;
Calcium (mg/dL)	8.2 ± 0.9	8.4 ± 1.1	0.699^b b p-value: calculated using the Mann-Whitney U test.

Variable	Beta	SE	p-value	OR	95%CI
Iron deficiency anemia	-0.950	0.545	0.082	0.4	(0.1-1.1)
Duration of undergoing hemodialysis (years)	-0.044	0.145	0.759	1.0	(0.7-1.3)
Uremic pruritus	-0.915	0.555	0.099	0.4	(0.1-1.2)
Hemoglobin	-0.304	0.183	0.096	0.7	(0.5-1.1)

Academia Brasileira de Neurologia - ABNEURO R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices Torre Norte, 04101-000 São Paulo SP Brazil, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revista.arquivos@abneuro.org

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Sergio Andrés Castillo-Torres; Servicio de Neurología, Hospital Universitario “Dr. José E. González” Universidad Autónoma de Nuevo León; Madero y Gonzalitos S/N, Col. Mitras Centro, Monterrey, NL, México. CP 64460. Telephone: +5218183471059. E-mail: sergio.castillotr@uanl.edu.mx