Abstract

BackgroundThe prevalence of Restless legs syndrome (RLS) in End Stage Renal Disease (ESRD) patients is higher than that in the general population. However, the associations of RLS within the ESRD population are inconsistent and RLS is usually neglected in dialysis centers, although it impairs the life quality among ESRD patients. We aim to investigate the prevalence of RLS in patients with ESRD undergoing maintenance hemodialysis and evaluate the risk factors of developing RLS and the effect of RLS on quality of life among ESRD patients.MethodsESRD patients undergoing maintenance hemodialysis in Shanghai General Hospital dialysis unit from July 2016 to October 2016 were enrolled in the study. RLS was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group (IRLSSG). IRLSSG Severity Scale was used to evaluate the severity of RLS. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and Hospital Anxiety and Depression Scale (HADS) was used to estimate anxiety and depression. Serologic and historic variables were analyzed to determine predictors of RLS in the ESRD population.ResultsA total of 137 ESRD patients were enrolled. The prevalence of RLS among the ESRD patients was 20.44%. The risk of RLS was increased significantly in females (OR = 2.729, p = 0.032) and daily alcohol drinkers (OR = 4.716, p = 0.022). RLS increased the risks of sleep disorders (25/28, 89.3% vs 73/109, 67.0%, p = 0.02) and sedative hypnotics intake (7/28, 25.0% vs 10/109, 9.2%, p = 0.047) and impaired the sleep quality (7/109 vs 11/28, p = 0.001) according to PSQI sum scores.ConclusionA high RLS prevalence among the ESRD patients undergoing hemodialysis was confirmed. ESRD patients who are women and drinking alcohol have a higher risk of RLS. The sleep quality was significantly impaired and sleeping medication use was more common among the ESRD patients with RLS.

Highlights

  • The prevalence of Restless legs syndrome (RLS) in End Stage Renal Disease (ESRD) patients is higher than that in the general population

  • Our study confirmed a high incidence of RLS among the ESRD patients undergoing maintenance hemodialysis

  • Among ESRD patients, the risk of RLS was significantly increased in females and alcohol users

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Summary

Introduction

The prevalence of Restless legs syndrome (RLS) in End Stage Renal Disease (ESRD) patients is higher than that in the general population. The associations of RLS within the ESRD population are inconsistent and RLS is usually neglected in dialysis centers, it impairs the life quality among ESRD patients. The prevalence of RLS in End Stage Renal Disease (ESRD) characterized as permanent loss of renal function requiring renal replacement therapy or dialysis, is 6.6–70%, which is much higher than the general population [4]. RLS in ESRD patients has been variably reported to be associated with female gender [5, 6], duration of dialysis [4, 7], diabetes mellitus [4, 8,9,10], iron deficiency anemia [4, 10, 11], parathyroid hormone [12], increased body mass index (BMI) [13], and increased homocysteine [14]. Results are very inconsistent. [10, 15]

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