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Restless legs syndrome in patients on dialysis  [cached]
Al-Jahdali Hamdan,Al-Qadhi Waleed,Khogeer Haithm,Al-Hejaili Fayez
Saudi Journal of Kidney Diseases and Transplantation , 2009,
Abstract: Restless legs syndrome (RLS) is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG). This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD) on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH), Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC), Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG′s RLS Questionnaire (RLSQ). Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 ± 17.2 years and mean duration on dialysis 40.4 ± 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM), coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively). Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS) (P= < 0.001 and 0.001, respectively). Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis and management of sleep disorders
Restless legs syndrome in patients on hemodialysis  [cached]
Salman Saleh Mohammad
Saudi Journal of Kidney Diseases and Transplantation , 2011,
Abstract: Restless legs syndrome (RLS) is common among dialysis patients, with a reported prevalence of 6-60%. The prevalence of RLS in Syrian patients on hemodialysis (HD) is not known. The purpose of this study is to determine the prevalence of RLS in patients on regular HD, and to find the possible correlation between the presence of RLS and demographic, clinical, and biochemical factors. One hundred and twenty-three patients (male/female = 70/53, mean age = 41.95 ± 15.11 years) on HD therapy at the Aleppo University Hospital were enrolled into the study. RLS was diagnosed based on criteria established by the International Restless Legs Syn-drome Study Group (IRLSSG). Data procured were compared between patients with and without RLS. Applying the IRLSSG criteria for the diagnosis, RLS was seen in 20.3% of the study pa-tients. No significant difference in age, gender, and intake of nicotine and caffeine was found between patients with and without the RLS. Similarly, there was no difference between the two groups in the duration of end-stage renal disease (ESRD), the period of dialysis dependence, dialysis adequacy, urea and creatinine levels, and the presence of anemia. The co-morbidities and the use of drugs also did not differ in the two groups. Our study suggests that the high prevalence of RLS among patients on HD requires careful attention and correct diagnosis can lead to better therapy and better quality of life. The pathogenesis of RLS is not clear and further studies are required to identify any possible cause as well as to discover the impact of this syndrome on sleep, quality of life, and possibly other complications such as cardiovasculare disease.
Restless legs syndrome in patients with hemodialysis
Hüseyin Atl?,Mehmet ??lbay,Serap Demir,?eref Yüksel
Medical Journal of Bakirk?y , 2008,
Abstract: Objective: The restless legs syndrome (RLS) is characterized by unpleasant sensations and pain in the legs, irresistible urge to move the legs, especially when resting and often accompanied by sleep disorders. RLS prevalence is up to 80% in hemodialysis patients. It is such an important clinical condition that is associated with increased mortality. Moreover etiopathogenesis is not clear. We aimed to evaluate vascular disorders, heart rate variability, oxidative stress parameter in hemodialysis patients with RLS. Material and Methods: Study was conducted with hemodialysis patients. Twenty five patients diagnosed as RLS with International Restless Legs Study Group criteria, and twenty five patients without RLS (control group) were included to the study. Patients were examined with complete blood count and biochemical assays, Kt/V, oxidative stress parameter such as malon dialdehyde and sulphydryl, lower extremity Doppler ultrasonography and 24 hour holter heart rate variability. Results: Patients with RLS had significantly lower hemoglobin and sodium levels (p:0.025 ve p:0.038). Tibialis posterior and anterior artery ow was significantly reduced in patients with RLS (p:0.011 ve p:0.010). There was significant correlation about low hemoglobin and sodium level and reduced tibialis posterior and anterior artery ow. With logistic regression analysis, only hemoglobin was determined as independent factor on RLS (OR 6.211 [%95 CI 1.368-26.176] p=0.018). Conclusion: It is concluded that hemoglobin is an important independent factor for progression to RLS. Therefore hemoglobin level must be maintained in normal range especially in patients with RLS.
Restless legs syndrome prevalence in patients on chronic hemodialysis in central Serbia  [PDF]
Niki? Petar M.,Andri? Branislav R.,Stojanovi?-Stanojevi? Marina,?or?evi? Verica
Vojnosanitetski Pregled , 2007, DOI: 10.2298/vsp0702129n
Abstract: Background/Aim. Restless legs syndrome (RLS) is a sensorymotor disorder and the core feature of this syndrome is a distressing, irresistible need or urge to move the legs. RLS is one of the most troublesome conditions experienced by endstage renal disease patients treated with regular hemodialysis, and is significantly associated with their increased mortality. The aim of this study was to assess the prevalence of RLS in the patients with end-stage renal failure in the three dialysis centers in central Serbia, and to investigate the association of the syndrome with clinical characteristics and biochemical variables. Methods. A cross-sectional multicentric study in which 166 consecutive hemodialysis patients were evaluated using a standard questionnaire based on diagnostic criteria elaborated by the International Restless Legs Syndrome Study Group was performed. All patients were reinterviewed and clinically examined by a qualified neurologist. The data on the patients with and without RLS were compared. Results. The prevalence of RLS was 22.96% (95% CI, 16.57% to 29.35%). There was no significant difference in duration of hemodialysis and clinical characteristics when we compared the patients with RLS with those without RLS. We found significantly higher levels of blood urea nitrogen and creatinine and lower level of Kt/V index in the patients with RLS, which might point to inadequate dialysis in these patients. Conclusion. In our study the prevalence of RLS in the patients on the regular hemodialysis was 22.96%. The obtained results are similar to those of other studies using the same methodology in the white population on the regular hemodialysis.
The Relationship between Iron Deficiency and Restless Legs Syndrome in Hemodialysis Patients
H Habibzadeh,M Hemmati Maslakpak,R Ghanei Gheshlagh
Journal of Shahid Sadoughi University of Medical Sciences , 2012,
Abstract: Introduction: Restless legs syndrome is a neurological disorder; hemodialysis patients seem to suffer more from this syndrome. Although the pathophysiology of restless legs syndrome is still unknown, assessment of factors associated with this syndrome can help to develop medical knowledge in this field. The present study assessed the relationship between restless legs syndrome, serum iron, and serum ferritin levels in patients on hemodialysis. Methods: This descriptive study was carried out with purposive sampling method on 168 hemodialysis patients who referred to the Urmia Taleghani Hospital Hemodialysis Unit. Data were gathered using restless legs syndrome questionnaire and laboratory Index of serum iron and ferritin. Data were analyzed using descriptive and inferential statistical tests. Results: The study results revealed that 38.7 percent of samples complained from restless legs syndrome whose average score serum iron was 78±29.3 μg. Results showed in hemodialysis patients with restless legs syndrome, serum iron and serum ferritin levels were significantly lower than hemodialysis patients without restless legs syndrome (p=0. 02, p=0.005). Conclusion: Considering the high prevalence of restless legs syndrome in patients with hemodialysis, identification of factors associated with this syndrome and providing the necessary solutions for modifying or eliminating the factors, seem to be necessary. Since the relationship between indicators of iron and ferritin and restless legs syndrome in hemodialysis patients is confirmed, the results can be helpful in the treatment and management of these patients.
Prevalence of restless legs syndrome in patients with irritable bowel syndrome
P Patrick Basu,N James Shah,Nithya Krishnaswamy,Tommy Pacana
World Journal of Gastroenterology , 2011, DOI: 10.3748/wjg.v17.i39.4404
Abstract: AIM: To determine the prevalence of restless legs syndrome (RLS) in patients with irritable bowel syndrome (IBS). METHODS: Patients with diarrhea-predominant IBS (n = 30), constipation-predominant IBS (n = 30), or mixed-symptom IBS (n = 30) were recruited from the community between March 2008 and February 2009. Rifaximin 200 mg three times daily was administered empirically to alleviate small intestinal bowel overgrowth in all patients. The presence of RLS was assessed via an RLS questionnaire and polysomnography. RESULTS: Twenty-six patients with IBS (29%) were diagnosed with RLS using the RLS questionnaire. Twenty-four of the 26 patients (92%) underwent polysomnography, and all had confirmation of RLS. A greater percentage of patients with RLS had diarrhea-predominant IBS (62%) compared with patients with constipation-predominant IBS (4%) or mixed-symptom IBS (33%). CONCLUSION: Restless legs syndrome is prevalent in patients with IBS, especially those with diarrheal symptoms. Assessment of concomitant disorders may improve diagnosis and expand relevant treatment options for patients.
RESTLESS LEGS SYNDROME IN COPD PATIENTS WITHOUT ACCOMPANYING DISEASE  [cached]
Zeynep Munteha Ba?er,Zeynep Zeren U?ar,Aydan Merto?lu,Cenk K?rakl?
Erciyes Medical Journal , 2012,
Abstract: Objective: Sleep problems, which may also affect mortality, frequently occur in chronic obstructive pulmonary disease (COPD) patients, but few studies have addressed sleep problems due to the restless legs syndrome (RLS). This study aimed to investigate the prevalence and severity of RLS and associated clinical and laboratory parameters in COPD patients without accompanying disease.Material and Methods: Fifty male COPD patients without accompanying disease and 20 male controls were enrolled to the study. RLS and RLS severity were assessed with a standard international questionnaire. Clinical and laboratory parameters which may be associated with RLS were investigated in COPD patients. Results: No statistically significant difference was found in the prevalence (COPD: 24%, controls: 10%) and severity of RLS. RLS family history was reported in 16% of COPD patients. No significant association existed between presence and severity of RLS and clinical and laboratory parameters. H A higher proportion of inhaled anticholinergic therapy was reported in COPD patients with RLS (11/12 vs 22/38; p<0.05).Conclusion: To our knowledge this is the first study which investigated the prevalence of RLS in COPD patients without accompanying disease and found an association between RLS and inhaled anticholinergic therapy. The major limitations were small sample size and lack of female patients. Large scale prospective studies would help to elicit these findings.
Evidence of Increased Muscle Atrophy and Impaired Quality of Life Parameters in Patients with Uremic Restless Legs Syndrome  [PDF]
Christoforos D. Giannaki,Giorgos K. Sakkas,Christina Karatzaferi,Georgios M. Hadjigeorgiou,Eleftherios Lavdas,Vassilios Liakopoulos,Nikolaos Tsianas,Georgios N. Koukoulis,Yiannis Koutedakis,Ioannis Stefanidis
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0025180
Abstract: Restless Legs Syndrome is a very common disorder in hemodialysis patients. Restless Legs Syndrome negatively affects quality of life; however it is not clear whether this is due to mental or physical parameters and whether an association exists between the syndrome and parameters affecting survival.
Restless legs syndrome in patients on chronic hemodialysis in a Brazilian city: frequency, biochemical findings and comorbidities
Goffredo Filho, Gilberto S.;Gorini, Cláudia C.;Purysko, Andrei S.;Silva, Herta C.;Elias, Ibrahim Eduardo F.;
Arquivos de Neuro-Psiquiatria , 2003, DOI: 10.1590/S0004-282X2003000500004
Abstract: objective: to evaluate the frequency of restless legs syndrome (rls) in patients with chronic renal failure (crf) in petrópolis, brazil, and investigate associations between the syndrome and: demographic characteristics, biochemical variables and comorbidities. method: a cross-sectional study in which we interviewed 176 patients on dialytic therapy based on criteria elaborated by the international restless legs syndrome study group, and compared data of patients with and without rls. results: the frequency was 14.8 %. there were no significant differences between the two groups in demographic and biochemical variables investigated (iron, creatinine, intact parathyroid hormone, hemoglobin, calcium, phosphate). we found no association between rls and the most common comorbidities, except for chronic glomerulonephritis (cgn) (or = 3.84, p < 0.01). conclusion: in the studied population rls is a common disorder, and is not associated with the investigated biochemical abnormalities. a higher frequency of rls in subjects with cgn is a finding that needs further investigation.
Restless legs syndrome in patients on chronic hemodialysis in a Brazilian city: frequency, biochemical findings and comorbidities  [cached]
Goffredo Filho Gilberto S.,Gorini Cláudia C.,Purysko Andrei S.,Silva Herta C.
Arquivos de Neuro-Psiquiatria , 2003,
Abstract: OBJECTIVE: To evaluate the frequency of restless legs syndrome (RLS) in patients with chronic renal failure (CRF) in Petrópolis, Brazil, and investigate associations between the syndrome and: demographic characteristics, biochemical variables and comorbidities. METHOD: A cross-sectional study in which we interviewed 176 patients on dialytic therapy based on criteria elaborated by the International Restless Legs Syndrome Study Group, and compared data of patients with and without RLS. RESULTS: The frequency was 14.8 %. There were no significant differences between the two groups in demographic and biochemical variables investigated (iron, creatinine, intact parathyroid hormone, hemoglobin, calcium, phosphate). We found no association between RLS and the most common comorbidities, except for chronic glomerulonephritis (CGN) (OR = 3.84, p < 0.01). CONCLUSION: In the studied population RLS is a common disorder, and is not associated with the investigated biochemical abnormalities. A higher frequency of RLS in subjects with CGN is a finding that needs further investigation.
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