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Restless legs syndrome in hemodialysis patients: association with depression and quality of life

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Abstract

Purpose

The prevalence of restless legs syndrome (RLS) ranging from 6.6% to 83% has been reported in different case series. The pathophysiology of RLS in uremia is still unclear. The aim of this study was to assess the frequency of RLS in the hemodialysis patients and to explore depression and associated detrimental impact on quality of life.

Methods

The diagnosis of RLS was made using the criteria of the International Restless Legs Study Group. The polyneuropathy was diagnosed according to clinical signs and symptoms. Each subject completed three questionnaires: Beck Depression Inventory, Short Form-36 Quality of Life Scale, and the Epworth Sleepiness Scale (ESS). Biochemical parameters including hemoglobin, serum ferritin, and Kt/V index were collected. The data of the patients with and without RLS or clinical polyneuropathy (PNP) were compared.

Results

There were 41 male and 40 female patients. RLS, PNP, and high ESS scores were seen in 12%, 47%, and 7% of hemodialysis patients, respectively. Beck depression inventory scores were high in patients with RLS when compared to those without (28.9 ± 9, p = 0.007). General health score in the RLS patients, physical functioning score in the PNP patients were significantly lower (GH, 20.7; p = 0.036; PF, 10.5; p < 0.005). We did not observe any association between hemoglobin, ferritin levels, and Kt/V index in the RLS patients. However, Kt/V index in the PNP patients were low.

Conclusions

The frequency of RLS in hemodialysis patients was lower than that reported from similar studies in other countries. The presence of RLS and PNP in hemodialyzed patients negatively affects quality of life, and RLS contributes to occurrence of depression.

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References

  1. Parker KP (2003) Sleep disturbances in dialysis patients. Sleep Med Rev 7:131–143

    Article  PubMed  Google Scholar 

  2. Merlino G, Piani A, Dolso P, Adorati M, Cancelli I, Valente M, Gigli GL (2006) Sleep disorders in patients with end-stage renal disease undergoing dialysis therapy. Nephrol Dial Transplant 21:184–190

    Article  PubMed  Google Scholar 

  3. Kosmadakis GC, Medcalf JF (2008) Sleep disorders in dialysis patients. Int J Artif Organs 31:919–927

    PubMed  CAS  Google Scholar 

  4. Spiegel BM, Melmed G, Robbins S, Esrailian E (2008) Biomarkers and health-related quality of life in end-stage renal disease: a systematic review. Clin J Am Soc Nephrol 3:1759–1768

    Article  PubMed  Google Scholar 

  5. Liem YS, Bosch JL, Arends LR, Heijenbrok-Kal MH, Hunink M (2007) Quality of life assessed with the medical outcomes study short form 36-item health survey of patients on renal replacement therapy: a systematic review and meta-analysis. Value Health 10:390–397

    Article  PubMed  Google Scholar 

  6. Murtagh FE, Addington-Hall J, Higginson IJ (2007) The prevalence of symptoms in end-stage renal disease: a systematic review. Adv Chron Kidney Dis 14:82–99

    Article  Google Scholar 

  7. Pichler I, Hicks AA, Pramstaller PP (2008) Restless legs syndrome: an update on genetics and future perspectives. Clin Genet 73:297–305

    Article  PubMed  CAS  Google Scholar 

  8. Allen RP, Walters A, Montplaisir J, Hening W, Myers A, Bell TJ, Ferini-Strambi L (2005) Restless legs syndrome prevalence and impact REST general population study. Arch Intern Med 165:1286–1292

    Article  PubMed  Google Scholar 

  9. Rıjsman RM, Weerd AWD, Stam CJ, Kerkhof GA, Romsan JB (2004) Periodic limb movement disorder and Restless Legs Syndrome in dialysis patients. Nephrology 9:353–361

    Article  PubMed  Google Scholar 

  10. Enomoto M, Inoue Y, Namba K, Munezawa T, Matsuura (2008) Clinical characteristics of Restless Legs Syndrome in end-stage renal failure and idiopathic RLS patients. Mov Disord 6:811–816

    Article  Google Scholar 

  11. Unruh ML, Levey AS, D’Ambrosio C, Fink NE, Powe NR, Meyer KB (2004) Choices for healthy outcomes in caring for end-stage renal disease (CHOICE) study restless legs symptoms among incident dialysis patients: association with lower quality of life and shorter survival. Am J Kidney Dis 43:900–909

    Article  PubMed  Google Scholar 

  12. Hojs-Fabjan T, Hojs R (2006) Polyneuropathy in hemodialysis patients: the most sensitive electrophysiological parameters and dialysis adequacy. Wien Klin Wochenschr 118:29–34

    Article  PubMed  Google Scholar 

  13. Tilki HE, Akpolat T, Coskun M, Stalberg E (2009) Clinical and electrophysiologic findings in dialysis patients. J Electromyogr Kinesiol 19:500–508

    Article  PubMed  Google Scholar 

  14. Molnar MZ, Novak M, Szeifert L, Ambrus C, Keszei A, Koczy A, Lindner A, Barotfi S, Szentkiralyi A, Remport A, Mucsi I (2007) Restless Legs Syndrome, insomnia, and quality of life after renal transplantation. J Psychosom Res 63:591–597

    Article  PubMed  Google Scholar 

  15. Novak M, Mendelssohn D, Shapiro CM, Mucsi I (2006) Diagnosis and management of sleep apnea syndrome and Restless Legs Syndrome in dialysis patients. Semin Dial 19:210–216

    Article  PubMed  Google Scholar 

  16. Bastos JP, Sousa RB, Nepomuceno LA, Gutierrez-Adrianzen OA, Bruin PF, Araújo ML, Bruin VM (2007) Sleep disturbances in patients on maintenance hemodialysis: role of dialysis shift. Rev Assoc Méd Bras 53:492–496

    Article  PubMed  Google Scholar 

  17. Chilcot J, Wellsted D, Da Silva-Gane M, Farrington K (2008) Depression on dialysis. Nephron Clin Pract 108:256–264

    Article  Google Scholar 

  18. Lopes AA, Albert JM, Young EW, Satayathum S, Pisoni RL, Andreucci VE, Mapes DL, Mason NA, Fukuhara S, Wikström B, Saito A, Port FK (2004) Screening for depression in hemodialysis patients: associations with diagnosis, treatment, and outcomes in the DOPPS. Kidney Int 66:2047–2053

    Article  PubMed  Google Scholar 

  19. Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisir J (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the Restless Legs Syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4:101–119

    Article  PubMed  Google Scholar 

  20. Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14:540–545

    PubMed  CAS  Google Scholar 

  21. Beck AT, Ward CH, Mendelson M (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    PubMed  CAS  Google Scholar 

  22. Hisli N (1989) Beck depresyon envanterinin üniversite ögrencileri için geçerlik ve güvenilirligi. Psikoloji Dergisi 7:3–13, Article in Turkish

    Google Scholar 

  23. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  24. Pinar R (2005) Reliability and construct validity of the SF-36 in Turkish cancer patients. Qual Life Res 14:259–264

    Article  PubMed  Google Scholar 

  25. Garcia-Borregueroa D, Egatza R, Winkelmannb J, Berger K (2006) Epidemiology of restless legs syndrome: the current status. Sleep Med Rev 10:153–167

    Article  Google Scholar 

  26. Ohayon MM, Roth T (2002) Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 53:547–554

    Article  PubMed  Google Scholar 

  27. Sevim S, Dogu O, Camdeviren H, Bugdayci R, Sasmaz T, Kaleagasi H, Aral M, Helvaci I (2003) Unexpectedly low prevalence and unusual characteristics of RLS in Mersin, Turkey. Neurology 61(11):1562–1569

    PubMed  CAS  Google Scholar 

  28. Gigli GL, Adorati M, Dolso P, Piani A, Valente M, Brotini S, Budai R (2004) Restless Legs Syndrome in end-stage renal disease. Sleep Med 5:309–315

    Article  PubMed  Google Scholar 

  29. Trenkwalder C (2007) Restless legs syndrome: overdiagnosed or underdiagnosed? Nat Clin Pract Neurol 3:474–475

    Article  PubMed  Google Scholar 

  30. Perl J, Unruh ML, Chan CT (2006) Sleep disorders in end-stage renal disease: markers of inadequate dialysis? Kidney Int 70:1687–1693

    Article  PubMed  CAS  Google Scholar 

  31. Molnar MZ, Novak M (2006) Management of Restless Legs Syndrome in patients on dialysis. Drugs 66:607–624

    Article  PubMed  CAS  Google Scholar 

  32. Micozkadioglu H, Ozdemir FN, Kut A, Sezer S, Saatci U, Haberal M (2004) Gabapentin versus levodopa for the treatment of Restless Legs Syndrome in hemodialysis patients: an open-label study. Ren Fail 26:393–397

    Article  PubMed  CAS  Google Scholar 

  33. Pai MF, Hsu SP, Yang SY, Ho TI, Lai CF, Peng YS (2007) Sleep disturbance in chronic hemodialysis patients: the impact of depression and anemia. Ren Fail 29:673–677

    Article  PubMed  Google Scholar 

  34. Gemignani F, Brindani F (2007) Restless legs syndrome associated with peripheral neuropathy. Eur J Neurol 14:9–10

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Faculty of Medicine, Department of Neurology, Kahramanmaras Sutcu Imam University, 46100, Kahramanmaras, Turkey

    Deniz Tuncel, Uygar Utku & Aytac Dinc

  2. Faculty of Medicine, Department of Psychiatry, Kahramanmaras Sutcu Imam University, 46100, Kahramanmaras, Turkey

    Fatma Özlem Orhan

  3. Faculty of Medicine, Department of Nephrology, Kahramanmaras Sutcu Imam University, 46100, Kahramanmaras, Turkey

    Hayriye Sayarlioglu

  4. Kahramanmamaras Phresinus Dialysis Center, 46100, Kahramanmaras, Turkey

    Ismet Onder Isık

Authors
  1. Deniz Tuncel
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  2. Fatma Özlem Orhan
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  3. Hayriye Sayarlioglu
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  4. Ismet Onder Isık
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  5. Uygar Utku
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  6. Aytac Dinc
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Corresponding author

Correspondence to Fatma Özlem Orhan.

Additional information

The authors confirm that all the research meets the ethical guidelines, including adherence to the legal requirements of the study country. Also, the authors had no conflicts of interest and no financial support for the study.

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

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  • DOI: https://doi.org/10.1007/s11325-010-0382-z

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