Iron and akathisia.

Blake, D R; Williams, A C; Pall, H; Fonseca, A. Cristina; Beswick, T. S. L.

doi:10.1136/bmj.292.6532.1393

Cited by 21 publications

(2 citation statements)

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“…Iron is a co-factor of the rate-limiting step required for conversion of tyrosine to levodopa, which is subsequently decarboxylated into dopamine [ 13 ]. Low levels of iron may induce or aggravate RLS by reducing the activity of the dopamine system [ 14 ]. Low ferritin and/or high transferrin levels in cerebrospinal fluid (CSF) may be present in RLS patients in comparison with healthy controls, even in the absence of low serum ferritin levels [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Intravenous Iron Sucrose in Hemodialysis Patients with Restless Legs Syndrome (RLS): A Randomized, Placebo-Controlled Study

2017

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BackgroundRestless legs syndrome (RLS) is a common disorder in hemodialysis (HD) patients that causes sleep disturbances and diminished quality of life. Because iron deficiency has been implicated in the pathogenesis of RLS, we sought to investigate the effects of intravenous (IV) iron sucrose on symptoms of RLS in HD patients.Material/MethodsThe study was a randomized, placebo-controlled study of 1000 mg iron sucrose versus normal saline as placebo. Patients were evaluated at baseline and 2 weeks after the last injection. The severity of RLS was assessed using the International RLS Study Group rating scale (IRLS). Blood samples were taken to measure iron parameters reflecting the iron status, including serum ferritin (SF) concentration, percentage transferrin saturation (TSAT%) and hemoglobin (Hb), and other biochemical parameters as safety assessments, including creatinine (Cr), urea, intact parathyroid hormone (iPTH), and the index of urea clearance (Kt/V). Adverse events were monitored in all subjects during the period of infusion.ResultsAfter 2 weeks, IRLS scores decreased more in the IV-iron group (−7.38±2.03) than in the placebo group (−0.81±2.61) (P=0.000). Serum ferritin, TSAT, and hemoglobin increased more in the IV-iron group (227.63±77.64 μg/L; 26.06±7.77%; 13.98±3.62g/L, respectively) than in the placebo group (SF, p=0.000; TSAT, p=0.000; Hb, p=0.000, respectively). There were no significant differences between IV-iron and placebo groups in Cr, urea, iPTH, and Kt/V. No adverse effects were observed in the study.ConclusionsIV iron sucrose is a safe and effective treatment for reducing RLS symptoms in HD patients over the short-term.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Intravenous Iron Sucrose in Hemodialysis Patients with Restless Legs Syndrome (RLS): A Randomized, Placebo-Controlled Study

2017

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“…και Van Putten και συν (359). αναφέρουν ότι, το άγχος και η κατάθλιψη πιθανόν να συνδέονται με την ακαθισία κατά την διάρκεια τόσο της οξείας όσο και της χρόνιας θεραπείας.Διάφοροι παθοφυσιολογικοί μηχανισμοί έχουν προταθεί για την ακαθισία, όπως, δέσμευση των ντοπαμινικών υποδοχέων στο μεσοφλοιώδες ντοπαμινικό σύστημα(370), εκλεκτική δέσμευση των προσυναπτικών ντοπαμινικών υποδοχέων(371), υποδραστηριότητα του συστήματος οπιοειδών (372), χαμηλά επίπεδα σιδήρου στον ορό(360)(361)(362), χωρίς όμως επί του παρόντος το θέμα αυτό να έχει πλήρως διευκρινιστεί. αποκλειστής (δεσμεύει τόσο τους κεντρικούς-βήτσ.2-, όσο και τους περιφερικούς-βήταΐ-αδρενεργικούς υποδοχείς).…”

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