Prevalence and Risk Factors of Restless Legs Syndrome in Hemodialysis Patients

Abstract

Objective

The current study aimed to investigate the prevalence and risk factors of restless legs syndrome (RLS) in patients undergoing hemodialysis, as well as the mortality and risks of cardiovascular and cerebrovascular events.

Methods

A total of 354 hemodialysis patients from four hospitals were enrolled. RLS was diagnosed using the International RLS Study Group (IRLSSG) criteria. The patients were evaluated face-to-face using the IRLSSG rating scale, Epworth Sleepiness Scale (ESS), Hamilton Anxiety Scale, Hamilton Depression Scale, and Pittsburgh Sleep Quality Index (PSQI). The patients were followed up for 9 months. Death was considered an endpoint event. The cardiovascular and cerebrovascular events were investigated.

Results

The prevalence of RLS in hemodialysis patients was 40.7% and was associated with factors such as duration of hemodialysis, hypersensitive C-reactive protein, hyperparathyroidism, glycosylated serum protein, and erythropoietin treatment. The scores of the PSQI, ESS, and Hamilton Depression Scale in the RLS group were significantly higher than those in the non-RLS group (p < 0.05). During follow-ups, the incidence rate of cardiovascular diseases was 18.8% in the RLS group and 8.6% in the non-RLS group (p < 0.005). The IRLSSG rating scores were significantly higher in RLS patients with kidney transplantation failure compared with those without transplantation (p < 0.05).

Conclusion

The prevalence of RLS was high in hemodialysis patients. The risk factors of RLS included duration of hemodialysis, hypersensitive C-reactive protein, hyperparathyroidism, glycosylated serum protein, and erythropoietin treatment. RLS affected sleep quality and emotion and increased the risk of cardiovascular diseases in hemodialysis patients. RLS was more severe in patients with kidney transplantation failure compared with those without transplantation.

Keywords:

• restless legs syndrome
• hemodialysis
• prevalence
• risk factor
• cardiovascular disease

Author Contributions

Li-Yan Zhang and Xiao-Yang Ma contributed to the study design, data collection, data analysis and draft of the initial manuscript. They contributed equally to the work. Jun Li, Wen-Hu Liu, Wang Guo, Xia Li, Jing Li and Li-Li Jin contributed to subject enrollment. Ze-Long Tian and Yi-Tong Du assisted in data collection and data analysis. Hou-Zhen Tuo conceptualized the study, contributed to data collection and analysis, and critically reviewed the manuscript. All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that the submitted article is not related to any financial interest/relationship and that they have no conflicts of interest in this work.

Additional information

Funding

This study was supported by a grant from the Beijing Municipal Commission of Education (KM201610025016). The funding body had no role in the conception, design, conduction, interpretation, or analysis of the study nor in the approval of the publication.