The association between the prevalence of restless leg syndrome, fatigue, and sleep quality in patients undergoing hemodialysis

Abstract

Objective:To determine the prevalence of restless legs syndrome (RLS) in patients with chronic renal failure (CRF) and to compare CRF patients with or without RLS in terms fatigue and sleep quality.Methods:A cross-sectional study was conducted on 220 patients (18-75 years) who were undergoing dialysis 3 times weekly in Çorum Province, Corum, Turkey, between January 2014 and January 2016. The diagnosis of RLS was based on the diagnostic form proposed by the international RLS study group. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI), and severity of fatigue was determined by using fatigue severity scale (FSS).Results:Of all the participants, 16.8% (n= 37) (Group 1) were found to have RLS, while 183 patients had no RLS (Group 2). The mean ages were similar between groups. With respect to laboratory analyses, a p-value of <0.05 was considered in Group 1 than in Group 2. Restless legs syndrome was mild (7.1%), moderate (46.4%) and severe (39.3%) in patients with RLS. Factors associated with the severity of RLS included weight, duration of dialysis, anuria, iron, total iron binding capacity, calcium and transferrin saturation. The PSQI and FSS scores were significantly worse in Group 1 (p<0.001).Conclusion:Restless legs syndrome is a common condition in patients undergoing hemodialysis; the results of our study confirm the adverse effects of RLS in terms of many aspects of sleep quality and fatigue.

Dialysis Patients With Restless Leg Syndrome: Can We Relieve Their Suffering?

“…The prevalence and associated risk factors with RLS in hemodialysis patients are highly variable in different populations. Based on the study conducted on 221 patients by Turk et al, the prevalence of RLS in hemodialysis patients in Turkey was estimated to be 16.8% [12]. The same study proclaimed that RLS is more prevalent in females (odds ratio [OR] = 0.435; 95% CI = 0.206-0.918; P = 0.029) [12].…”

“…Based on the study conducted on 221 patients by Turk et al, the prevalence of RLS in hemodialysis patients in Turkey was estimated to be 16.8% [12]. The same study proclaimed that RLS is more prevalent in females (odds ratio [OR] = 0.435; 95% CI = 0.206-0.918; P = 0.029) [12]. Also, high serum ferritin (OR =1.002; 95% CI =1.000-1.003; P =0.009) and c-reactive protein (CRP) (OR = 1.021; 95% CI = 1.021-1.039; P = 0.02) were found with other risk factors for RLS in these patients [12].…”

“…RLS pathophysiology is not entirely understood; it can be due to dopamine imbalance, decreased iron stores in the brain, or iron regulation disturbances [11]. Smoking, caffeine intake, alcohol intake, hypertension, diabetes mellitus, and female sex are risk factors associated with RLS [12].…”

“…There is a positive correlation between fatigue severity and RLS severity [12]. RLS is also associated with depression, anxiety, and sexual dysfunction [12,13]. It is associated with a significantly higher risk of cardiovascular morbidity and mortality [12].…”

“…RLS is also associated with depression, anxiety, and sexual dysfunction [12,13]. It is associated with a significantly higher risk of cardiovascular morbidity and mortality [12]. According to previous studies, RLS symptoms in the uremic patient are more severe than in patients with primary RLS [14].…”