Evidence of Increased Muscle Atrophy and Impaired Quality of Life Parameters in Patients with Uremic Restless Legs Syndrome

Giannaki, Christoforos D.; Sakkas, Giorgos K.; Karatzaferi, Christina; Hadjigeorgiou, Georgios M.; Lavdas, Eleftherios; Liakopoulos, Vassilios; Tsianas, Nikolaos; Koukoulis, G.; Koutedakis, Yiannis; Stefanidis, Ioannis

doi:10.1371/journal.pone.0025180

Cited by 57 publications

(51 citation statements)

References 49 publications

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“…This result is consistent with previously reported high prevalence rates of the disease in these patients [6,7,12,13]. Moreover, in line with earlier studies, the onset of symptoms was related to the beginning of HD in most cases [13,32]. RLS/WED symptoms in ESRD are usually more severe than in idiopathic forms [31], and we confirmed a high prevalence of RLS/WED-associated OLC/NOS [32].…”

Section: Discussionsupporting

confidence: 94%

“…The disease can occur as a primary disorder (sporadic or familial) or be symptomatic associated with facilitating comorbid conditions, such as iron deficiency, pregnancy, peripheral neuropathy or renal failure [5]. RLS/WED has a prevalence rate of approximately 30% in patients with end-stage renal disease (ESRD) [6,7,8,9,10,11,12,13,14,15]. The exact pathogenic mechanisms responsible for uremic RLS/WED remain unknown.…”

Section: Introductionmentioning

confidence: 99%

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Survival of Dialysis Patients with Restless Legs Syndrome: A 15-Year Follow-Up Study

Baiardi

Mondini²,

Antognini³

et al. 2017

Am J Nephrol

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Background: Restless legs syndrome, also known as Willis/Ekbom disease (RLS/WED), is a sleep-related, sensorimotor disorder with a high prevalence among end-stage renal disease (ESRD) patients undergoing haemodialysis (HD) (about 15-40%). Whether RLS/WED in uremic patients influences cardiovascular morbidity and mortality remains a matter of controversy. The aim of this study was to evaluate the relationship of RLS/WED and mortality in a population of chronically dialyzed patients. Method: In 1996, we studied 128 patients with ESRD undergoing HD; 47 subjects (36.7%) complained RLS/WED symptoms. Fifteen years later we evaluated the mortality of this population. No clinical follow-up examination of the uremic population was made. The Kaplan-Maier curves in dialysis patients with or without RLS/WED (control group matched for age) were constructed for all-cause mortality and compared using log-rank test. Results: The Kaplan-Maier curves disclosed a lower mortality rate in the uremic patients with RLS/WED than in those without RLS/WED (p = 0.04). In our analysis, the mortality rate was not influenced by RLS/WED severity (p = 0.11) or gender (p = 0.15). No difference among the causes of death was found in the 2 groups. Conclusions: Our study suggests that mortality in ESRD patients is not influenced by concomitant RLS/WED. After a 15-year follow-up, survival rates in our cohort were significantly longer in uremic subjects with RLS/WED than in those without RLS/WED. Finally, we found no relationship between RLS/WED severity and mortality.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Survival of Dialysis Patients with Restless Legs Syndrome: A 15-Year Follow-Up Study

Baiardi

Mondini²,

Antognini³

et al. 2017

Am J Nephrol

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“…[11,19,20]. According to the IRLSSG rating scale, severity was classified as mild (<11 on the IRLSSG rating scale), moderate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), severe (21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and very severe (31)(32)(33)(34)(35)(36)(37)(38)(39)(40) [21]. The Page 6 of 35 prevalence of RLS found in that study was 26.6% (154/579).…”

Section: Methodsmentioning

confidence: 95%

“…It seems that the common denominator of those factors is the detrimental effect of RLS on sleep, which in turn affects a number of physiological and psychological parameters that may be associated with increased mortality. Briefly, uremic RLS has been reported to be associated with diabetes mellitus [13], chronic inflammation, as indicated by the increased C-reactive protein levels [15], and sleep impairment [33,37], a factor that is well known to be associated with a cascade of pathological conditions that affect health and mortality [38].…”

Section: Page 12 Of 35mentioning

confidence: 99%

Restless legs syndrome does not affect 3-year mortality in hemodialysis patients

et al. 2015

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Original Highlights of the studyWe evaluated the relationship of RLS and mortality in chronic hemodialysis patients For the diagnosis of RLS we implemented standard methodology, i.e. the essential clinical criteria of the International RLS Study Group. This is the first time this issue is investigated in an epidemiological survey in Greece.In contrast to previous reports the diagnosis of RLS does not influence the 3-year mortality in HD patients. ABSTRACTObjective: In chronic hemodialysis (HD) patients, the prevalence of restless legs syndrome (RLS) is significantly higher than in the general population. Uremic RLS has been related to an enhanced mortality of HD patients. In the general population, however, studies of this association have yielded inconsistent results. The aim of the present study was to re-evaluate the relationship of RLS and mortality in HD patients. Methods:We recorded the 3-year mortality rate in a population of 579 HD patients after assessment for RLS symptoms. In addition we analyzed the 5-year mortality rate after end-stage renal disease onset (i.e., commencement of HD). This HD patient population has been previously included in a cross-sectional survey of RLS prevalence in which RLS diagnosis was based on the essential clinical criteria of the International RLS Study Group. Mortality data were acquired from the national endstage renal disease registry. Survival probability was calculated by means of the Kaplan-Meier method and analyzed by the log-rank (Mantel-Cox) test. For multivariate survival analysis, we implemented a proportional hazards regression Conclusion: Diagnosis of RLS according to the essential clinical criteria of theInternational RLS Study Group does not seem to influence the 3-year mortality in HD patients. Our findings are in contrast to those in some previous reports, and reinforce the need for further studies of RLS and mortality in HD patients.

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“…A recent cross-sectional study between control group, renal transplantation group and hemodialysis group found that prevalence in renal transplantation is significantly lower than in hemodialysis patients (Kahvecioglu et al, 2016). RLS is very prevalent in end-stage renal disease patients, and hemodialysis patients with RLS were found to have a higher risk of muscle atrophy (Giannaki et al, 2011), cardio/cerebrovascular events and mortality (Lin C.H. et al, 2015).…”

Section: Secondary Rlsmentioning

confidence: 99%

Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management

Guo

Huang

Jiang

et al. 2017

Front. Aging Neurosci.

130

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Restless legs syndrome (RLS), a common neurological sensorimotor disorder in western countries, has gained more and more attention in Asian countries. The prevalence of RLS is higher in older people and females. RLS is most commonly related to iron deficiency, pregnancy and uremia. The RLS symptoms show a significant circadian rhythm and a close relationship to periodic limb movements (PLMs) in clinical observations, while the pathophysiological pathways are still unknown. The diagnostic criteria have been revised in 2012 to improve the validity of RLS diagnosis. Recent studies have suggested an important role of iron decrease of brain in RLS pathophysiology. Dopaminergic (DA) system dysfunction in A11 cell groups has been recognized long ago from clinical treatment and autopsy. Nowadays, it is believed that iron dysfunction can affect DA system from different pathways and opioids have a protective effect on DA system. Several susceptible single nucleotide polymorphisms such as BTBD9 and MEIS1, which are thought to be involved in embryonic neuronal development, have been reported to be associated with RLS. Several pharmacological and non-pharmacological treatment are discussed in this review. First-line treatments of RLS include DA agents and α2δ agonists. Augmentation is very common in long-term treatment of RLS which makes prevention and management of augmentation very important for RLS patients. A combination of different types of medication is effective in preventing and treating augmentation. The knowledge on RLS is still limited, the pathophysiology and better management of RLS remain to be discovered.

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Evidence of Increased Muscle Atrophy and Impaired Quality of Life Parameters in Patients with Uremic Restless Legs Syndrome

Cited by 57 publications

References 49 publications

Survival of Dialysis Patients with Restless Legs Syndrome: A 15-Year Follow-Up Study

Survival of Dialysis Patients with Restless Legs Syndrome: A 15-Year Follow-Up Study

Restless legs syndrome does not affect 3-year mortality in hemodialysis patients

Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management

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