Restless legs syndrome in end-stage renal disease patients on maintenance hemodialysis: Quality of life and sleep analysis

© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Download PDF

Cite

XML

Abstract

Vitamin D insufficiency, calcium/phosphate imbalance, iron deficiency, anemia, pregnancy, and end-stage renal disease (ESRD) are all thought to be involved in the pathogenesis of restless leg syndrome (RLS). The prevalence of RLS ranging from 6.6% to 83% has been reported in another study. It is one of the illnesses that affect the quality of life of ESRD patients on maintenance hemodialysis. Unfortunately, RLS has not received enough recognition and attention, and the underdiagnosed and undertreated rate can reach more than 10%. This study aimed to look at the sleep quality and quality of life of people with RLS who were on maintenance hemodialysis. The present study included 286 individuals on chronic dialysis. The International Restless Legs Syndrome Study Group Diagnostic Criteria and the International RLS Rating Scale were used as recommendations to diagnose and assess the severity of RLS. The Pittsburgh sleep quality index (PSQI) and the Short Form-36 Health Survey (SF-36) were employed to evaluate sleep quality and quality of life. All patients’ biochemical and demographic data were reviewed, and statistical analyses were carried out. In conclusion, there were no statistically significant variations in demographic information or clinical and laboratory characteristics between RLS patients and those who did not have RLS. Specifically, among dialysis patients, those with RLS had higher PSQI and SF-36 ratings.

Keywords

Restless legs syndrome

End-stage renal disease

Maintenance dialysis

Quality of life

Quality of sleep

Funding

Yuan Du Scholars and Weifang Key Laboratory and Clinical Research Project Program of Affiliated Hospital of Weifang Medical University

References

[1]

Xiao JP, Zhang GX, Chen L, et al., 2017, Restless legs syndrome in maintenance hemodialysis patients: An epidemiologic survey in Hefei. Int Urol Nephrol, 49: 1267–1272.

[2]

Sahli ZT, Jo J, Mousa SA, et al., 2017, Clinical management of restless legs syndrome in end-stage renal disease patients. CNS Spectr, 22:14–21. https://doi.org/10.1017/S109285291600064X

[3]

Li Y, Walters AS, Chiuve SE, et al., 2012, Prospective study of restless legs syndrome and coronary heart disease among women. Circulation, 126:1689–1694.

[4]

Zhang Y, Zhao JH, Huang D, et al., 2020, Multiple comorbid sleep disorders adversely affect quality of life in Parkinson’s disease patients. NPJ Parkinsons Dis, 6: 25.

[5]

Vlasie A, Trifu SC, Lupuleac C, et al., 2022, Restless legs syndrome: An overview of pathophysiology, comorbidities and therapeutic approaches (Review). Exp Ther Med, 23: 185. https://doi.org/10.3892/etm.2021.11108

[6]

Kambampati S, Wasim S, Kukkar V, et al., 2020, Restless leg syndrome in the setting of patients with end-stage renal disease on hemodialysis: A literature review. Cureus, 12: e99657. https://doi.org/10.7759/cureus.9965

[7]

Tuncel D, Orhan FO, Sayarlioglu H, et al., 2011, Restless legs syndrome in hemodialysis patients: Association with depression and quality of life. Sleep Breath, 15:311–315.

[8]

Collister D, Rodrigues JC, Mazzetti A, et al., 2019, Screening questions for the diagnosis of restless legs syndrome in hemodialysis. Clin Kidney J, 12: 559–563. https://doi.org/10.1093/ckj/sfy129

[9]

Quinn C, Uzbeck M, Saleem I, et al., 2011, Iron status and chronic kidney disease predict restless legs syndrome in an older hospital population. Sleep Med, 12: 295–301. https://doi.org/10.1016/j.sleep.2010.08.014

[10]

Manconi M, Garcia-Borreguero D, Schormair B, et al., 2021, Restless legs syndrome. Nat Rev Dis Primers, 7: 80. https://doi.org/10.1038/s41572-021-00311-z

[11]

Erdogan A, Dervisoglu E, Kutlu A, 2012, Sleep quality and its correlates in patients on continuous ambulatory peritoneal dialysis. Scand J Urol Nephrol, 46: 441–447. https://doi.org/10.3109/00365599.2012.693134

[12]

Yatsu S, Kasai T, Suda S, et al., 2019, Prevalence and significance of restless legs syndrome in patients with coronary artery disease. Am J Cardiol, 123: 1580–1586. https://doi.org/10.1016/j.amjcard.2019.02.017

[13]

Memon MD, Faiz S, Zaveri MP, et al., 2020, Unraveling the mysteries of restless leg syndrome. Cureus, 12: e10951. https://doi.org/10.7759/cureus.10951

[14]

Barzegar M, Bahmani DS, Nehzat N, et al., 2019, Comparison of sleep complaints and quality of life between patients with neuromyelitis optica spectrum disorder (NMOSD) and healthy controls. Mult Scler Relat Disord, 32: 81–87. https://doi.org/10.1016/j.msard.2019.04.008

[15]

Bian Z, Zhang Q, Shen L, et al., 2022, The effect of sodium thiosulfate on coronary artery calcification in hemodialysis patients. ASAIO J, 68: 402–406. https://doi.org/10.1097/MAT.0000000000001531

[16]

Schneider R, Karakas E, Bartsch DK, et al., 2013, The influence of parathyroidectomy on restless legs syndrome in patients with renal hyperparathyroidism. World J Surg, 37: 2866–2871. https://doi.org/10.1007/s00268-013-2185-4

[17]

Santos RS, Coelho FM, da Silva BC, et al., 2016, Parathyroidectomy improves restless leg syndrome in patients on hemodialysis. PLoS One, 11: e0155835. https://doi.org/10.1371/journal.pone.0155835

[18]

Lin CH, Wu VC, Li WY, et al., 2013, Restless legs syndrome in end-stage renal disease: A multicenter study in Taiwan. Eur J Neurol, 20: 1025–1031. https://doi.org/10.1111/ene.12095

[19]

Jaber BL, Schiller B, Burkart JM, et al., 2011, Impact of short daily hemodialysis on restless legs symptoms and sleep disturbances. Clin J Am Soc Nephrol, 6: 1049–1056. https://doi.org/10.2215/CJN.10451110

[20]

Lindner A, Fornadi K, Lazar AS, et al., 2012, Periodic limb movements in sleep are associated with stroke and cardiovascular risk factors in patients with renal failure. J Sleep Res, 21: 297–307. https://doi.org/10.1111/j.1365-2869.2011.00956.x

[21]

Jung HH, Lee JH, Baek HJ, et al., 2010, Nocturnal hypoxemia and periodic limb movement predict mortality in patients on maintenance hemodialysis. Clin J Am Soc Nephrol, 5: 1607–1613. https://doi.org/10.2215/CJN.08881209

[22]

Tsai LH, See LC, Chien CC, et al., 2019, Risk factors for restless legs syndrome in hemodialysis patients in Taiwan: A case-control study. Medicine (Baltimore), 98: e18450. https://doi.org/10.1097/MD.0000000000018450

[23]

Giannaki CD, Sakkas GK, Karatzaferi C, et al., 2011, Evidence of increased muscle atrophy and impaired quality of life parameters in patients with uremic restless legs syndrome. PLoS One, 6: e25180. https://doi.org/10.1371/journal.pone.0025180

[24]

Dauvilliers Y, Benes H, Partinen M, et al., 2016, Rotigotine in hemodialysis-associated restless legs syndrome: A randomized controlled trial. Am J Kidney Dis, 68: 434–443. https://doi.org/10.1053/j.ajkd.2015.12.027

[25]

Cederberg KL, Jeng B, Sasaki JE, et al., 2020, Restless legs syndrome and health-related quality of life in adults with multiple sclerosis. J Sleep Res, 29: e12880. https://doi.org/10.1111/jsr.12880

[26]

Giannaki CD, Hadjigeorgiou GM, Karatzaferi C, et al., 2013, A single-blind randomized controlled trial to evaluate the effect of 6 months of progressive aerobic exercise training in patients with uraemic restless legs syndrome. Nephrol Dial Transplant, 28: 2834–2840. https://doi.org/10.1093/ndt/gft288

[27]

Yang B, Xu J, Xue Q, et al., 2015, Non-pharmacological interventions for improving sleep quality in patients on dialysis: Systematic review and meta-analysis. Sleep Med Rev, 23: 68–82.https://doi.org/10.1016/j.smrv.2014.11.005

[28]

Tuncel D, Orhan FO, Sayarlioglu H, et al., 2011, Restless legs syndrome in hemodialysis patients: Association with depression and quality of life. Sleep Breath, 15: 311–315. https://doi.org/10.1007/s11325-010-0382-z

[29]

Cengic B, Resic H, Spasovski G, et al., 2012, Quality of sleep in patients undergoing hemodialysis. Int Urol Nephrol, 44: 557–567. https://doi.org/10.1007/s11255-010-9881-x

[30]

Merlino G, Lorenzut S, Romano G, et al., 2012, Restless legs syndrome in dialysis patients: A comparison between hemodialysis and continuous ambulatory peritoneal dialysis. Neurol Sci, 33: 1311–1318. https://doi.org/10.1007/s10072-012-0953-9

[31]

La Manna G, Pizza F, Persici E, et al., 2011, Restless legs syndrome enhances cardiovascular risk and mortality in patients with end-stage kidney disease undergoing long-term haemodialysis treatment. Nephrol Dial Transplant, 26: 1976–1983. https://doi.org/10.1093/ndt/gfq681

[32]

Pizza F, Persici E, La Manna G, et al., 2012, Family recurrence and oligo-anuria predict uremic restless legs syndrome. Acta Neurol Scand, 125:403–409. https://doi.org/10.1111/j.1600-0404.2011.01581.x

[33]

Lee J, Nicholl DD, Ahmed SB, et al., 2013, The prevalence of restless legs syndrome across the full spectrum of kidney disease. J Clin Sleep Med, 9: 455–459. https://doi.org/10.5664/jcsm.2664

[34]

Salman SM, 2011, Restless legs syndrome in patients on hemodialysis. Saudi J Kidney Dis Transpl, 22: 368–372.

[35]

Stefanidis I, Vainas A, Dardiotis E, et al., 2013, Restless legs syndrome in hemodialysis patients: An epidemiologic survey in Greece. Sleep Med, 14: 1381–1386. https://doi.org/10.1016/j.sleep.2013.05.022

[36]

Soumeila I, Keita S, Elhassani A, et al., 2015, The restless legs syndrome: Incidence and risk factors in hemodialysis. Pan Afr Med J, 20: 29.

[37]

Wali SO, Alkhouli AF, 2015, Restless legs syndrome among Saudi end-stage renal disease patients on hemodialysis. Saudi Med J, 36: 204–210. https://doi.org/10.15537/smj.2015.2.10036

[38]

Demircioglu DT, Kavadar G, Ore OE, et al., 2015, Relationship between restless leg syndrome and quality of life in uremic patients. Agri, 27: 73–78. https://doi.org/10.5505/agri.2015.19327

[39]

Örsal Ö, Ünsal A, Balcı-Alparslan G, et al., 2017, Restless legs syndrome and sleep quality in patients on hemodialysis. Nephrol Nurs J, 44: 167–176.

[40]

Esteve V, Carneiro J, Salazar G, et al., 2018, Effects of rotigotine on clinical symptoms, quality of life and sleep hygiene adequacy in haemodialysis-associated restless legs syndrome. Nefrologia (Engl Ed), 38: 79–86. https://doi./org/10.1016/j.nefro.2017.03.023

[41]

Baiardi S, Mondini S, Antognini AB, et al., 2017, Survival of dialysis patients with restless legs syndrome: A 15-year follow-up study. Am J Nephrol, 46: 224–230.

[42]

Liaveri PG, Dikeos D, Ilias I, et al., 2017, Quality of sleep in renal transplant recipients and patients on hemodialysis. J Psychosom Res, 93: 96–101. https://doi.org/10.1016/j.jpsychores.2016.12.013

[43]

Neves PD, Graciolli FG, Oliveira IB, et al., 2017, Effect of mineral and bone metabolism on restless legs syndrome in hemodialysis patients. J Clin Sleep Med, 13: 89–94. https://doi.org/10.5664/jcsm.6396

[44]

Kaya T, Acar BA, Sipahi S, et al., 2015, Relationships between malnutrition, inflammation, sleep quality, and restless legs syndrome in hemodialysis patients. Ther Apher Dial, 19: 497–502. https://doi.org/10.1111/1744-9987.12313

[45]

Higuchi T, Abe M, Mizuno M, et al., 2015, Association of restless legs syndrome with oxidative stress and inflammation in patients undergoing hemodialysis. Sleep Med, 16: 941–948. https://doi.org/10.1016/j.sleep.2015.03.025

[46]

Rohani M, Aghaei M, Jenabi A, et al., 2015, Restless legs syndrome in hemodialysis patients in Iran. Neurol Sci, 36: 723–727. https://doi.org/10.1007/s10072-014-2026-8

[47]

Beladi-Mousavi SS, Jafarizade M, Shayanpour S, et al., 2015, Restless legs syndrome: associated risk factors in hemodialysis patients. Nephrourol Mon, 7: e31967. https://doi.org/10.5812/numonthly.31967

[48]

Chavoshi F, Einollahi B, Haghighi KS, et al., 2015, Prevalence and sleep related disorders of restless leg syndrome in hemodialysis patients. Nephrourol Mon, 7: e24611. https://doi.org/10.5812/numonthly.24611

[49]

Giannaki CD, Hadjigavriel M, Lazarou A, et al., 2017, Restless legs syndrome is contributing to fatigue and low quality of life levels in hemodialysis patients. World J Nephrol, 6: 236–242. https://doi.org/10.5527/wjn.v6.i5.236

[50]

Bathla N, Gupta R, Ahmad S, et al., 2016, Prevalence and correlates of Willis-Ekbom’s disease/restless legs syndrome in patients undergoing hemodialysis. Saudi J Kidney Dis Transpl, 27: 685–691. https://doi.org/10.4103/1319-2442.185224

[51]

Stefanidis I, Vainas A, Giannaki CD, et al., 2015, Restless legs syndrome does not affect 3-year mortality in hemodialysis patients. Sleep Med, 16: 1131–1138. https://doi.org/10.1016/j.sleep.2015.04.023

[52]

De Santo RM, Di Iorio AP, 2010, Sleep disorders in kidney disease. Minerva Urol Nefrol, 62: 111–128.

[53]

Dikici S, Bahadir A, Baltaci D, et al., 2014, Association of anxiety, sleepiness, and sexual dysfunction with restless legs syndrome in hemodialysis patients. Hemodial Int, 18: 809–818. https://doi.org/10.1111/hdi.12175

Conflict of interest

The authors declare that they have no competing interests.

Previous article in this issue

Next article in this issue

Advanced Neurology, Electronic ISSN: 2810-9619 Published by AccScience Publishing