Association between predialysis hypermagnesaemia and morbidity of uraemic restless legs syndrome in maintenance haemodialysis patients: a retrospective observational study in Zhejiang, China

Abstract

ObjectiveThe aim of the present study was to determine whether the predialysis serum magnesium level was associated with morbidity of uraemic restless legs syndrome (RLS) in maintenance haemodialysis patients.DesignA retrospective observational study of morbidity of uraemic RLS was conducted.SettingPatients on maintenance haemodialysis three times a week.ParticipantsWe reviewed 578 patients receiving maintenance haemodialysis for >1 year as our cohort.Outcome measuresUraemic RLS was diagnosed according to International RLS Study Group criteria, and hypermagnesaemia was defined as serum magnesium level >1.02 mmol/L.ResultsThe prevalence of uraemic RLS was 14.4% in our study cohort. Univariate analysis indicated that patients with uraemic RLS differed significantly from non-RLS ones in certain demographic and clinical characteristics, including younger age, longer dialysis duration, higher serum parathyroid hormone level and higher prevalence of predialysis hyperphosphataemia and hypermagnesaemia. Binary logistic-regression model analysis indicated that predialysis hypermagnesaemia was independently associated with uraemic RLS and conferred an increase in morbidity of the syndrome (OR=2.024; 95% CI 1.160 to 3.532; p=0.013). Moreover, we found that dialysis duration and predialysis hyperphosphataemia were independently associated with morbidity of uraemic RLS.ConclusionsOur data indicated that the predialysis serum magnesium level was associated with morbidity of uraemic RLS in maintenance haemodialysis patients and that predialysis hypermagnesaemia might serve as an independent risk factor for the syndrome.

Serum Trace Elements Concentrations in Patients with Restless Legs Syndrome

“…In contrast, a prospective case-control questionnaire study for RLS involving 600 pregnant women showed a significantly higher magnesium intake in patients with RLS than in those without RLS [ 39 ]. In addition, a recent retrospective study involving 578 ESRD patients receiving maintenance haemodialysis for more than 1 year has shown an association of pre-dialysis hypermagnesemia both with uraemic RLS and with increased morbidity of this syndrome [ 40 ]. The results of these studies [ 39 , 40 ] are along the same lines as our finding of increased serum magnesium levels in patients with iRLS (none of the women included in our study were pregnant) in comparison with controls.…”

Restless Leg Syndrome in Hemodialysis Patients

“…[34][35][36][37][38] Some studies have found that the length of the dialysis period may determine RLS occurrence. [39][40][41] Yang et al 42 showed that predialysis hypermagnesaemia might be an independent risk factor for RLS. The mean age of ESRD patients appears to have no association with the presence of RLS.…”

Global prevalence of restless legs syndrome among hemodialysis patients: A systematic review and meta‐analysis

“…Moreover, HD -related RLS is associated with a variety of physical and psychological disorders, such as insomnia, fatigue, anxiety, and depression, which seriously affect patients' prognosis and quality of life and even lead to an increased risk of cardiovascular events and death (Mousavi et al, 2021;Stergiannis et al, 2020;Tuncel et al, 2011Tuncel et al, , 2019Tsai et al, 2019;Yang et al, 2019;Zhang et al, 2020).…”

“…However, patients on HD are more vulnerable to RLS due to ferritin loss and changes in phosphate and parathyroid hormone levels, suggesting that HD is a significant risk factor for RLS (Huzmeli et al., 2018; Ramachandran et al., 2018). Moreover, HD ‐related RLS is associated with a variety of physical and psychological disorders, such as insomnia, fatigue, anxiety, and depression, which seriously affect patients’ prognosis and quality of life and even lead to an increased risk of cardiovascular events and death (Mousavi et al., 2021; Stergiannis et al., 2020; Tuncel et al., 2011, 2019; Tsai et al., 2019; Yang et al., 2019; Zhang et al., 2020).…”