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Advanced Neurologyurology
Advanced Ne Restless legs syndrome in end-stage renal disease patients

Despite the significant frequency of sleep disruption the study. Exclusion criteria of then present study are as
in MHD patients, the causes remain unclear and are follows: (i) Those who had disturbance of consciousness,
likely multifaceted. RLS has been shown to harm many severe dysarthria, aphasia and cognitive disorders;
elements of quality of life and sleep quality, which may (ii) those who had severe auditory or visual impairment,
trigger sadness and anxiety . Furthermore, studies have and physical frailty that prevented interview attendance;
[1]
found that premature dialysis termination is linked to (iii) those who had severe comorbidities (e.g., heart disease,
RLS symptoms, poor transferrin saturation levels due to lung disease, liver disease, kidney dysfunction, nutritional
iron insufficiency, and sleep start delay . In addition, RLS deficiency, electrolyte disorder, severe endocrine and
[2]
was associated with an increased risk of death, and the infectious diseases, neuropsychiatric complications, and
relationship was somewhat reduced when controlling for mental illness) that could affect follow-up assessment;
sleep-related disorders [1,3,4] . Furthermore, after correcting (iv) those who were using antipsychotics, dopamine
for comorbidities, demographic factors, and possible agonists, and nerves nutritional drugs; (v) those with a
clinical confounders, severe restless legs symptoms history of central nervous system disease (such as tumor,
were independently related to elevated mortality risk . trauma, hydrocephalus, Parkinson’s disease, dementia),
[5]
A recent study by Kambampati et al. has shown that malignancies, human immunodeficiency disease and
[6]
sleep fragmentation and sleep deprivation induced by opportunistic infections; (vi) those who did not provide
RLS may contribute to cardiovascular problems and comprehensive records and lost to follow-up; and
inflammatory infections, frequently resulting in a poor (vii) those who refused to participate and sign the written
prognosis in dialysis patients. Complete analyses of RLS- consent. Figure 1 shows the flow chart of study and patient
related quality of life and sleep disruption, which may selection.
lead to specialized treatment, are time-consuming and
difficult. We anticipated that RLS is a prevalent illness 2.2. Clinical assessments
in these individuals because of concomitant conditions, 2.2.1. Patient characteristics
such as iron metabolism disorders, dialysis-related We collected the basic demographic parameters related
variables, systemic inflammation, peripheral neuropathy, to age, gender, smoking, alcohol intake, history of renal
diabetes mellitus, and electrolyte imbalance . In general, disease, and comorbid disease (chronic glomerulonephritis,
[7]
the purpose of this study was to investigate the link diabetic mellitus, and hypertension), information
between LRS and common sleep disorders, as well as the regarding dialysis therapy (such as age at initiation,
possible consequences on quality of life parameters . duration of chronic kidney disease, time of dialysis, the
[2]
RLS treatment improves clinical outcomes in dialysis
patients. The general measures include reduced possible delivered dose of dialysis [Kt/V], dry weigh, ultrafiltration
aggravating variables such as living standards, medical volume, pre/post-dialysis mean systolic/diastolic blood
issues, and drugs . The revious research has suggested pressure [BP]), biochemical parameters (blood urea
[8]
that a dopamine receptor agonist treatment drug might nitrogen [BUN], creatinine, albumin, hemoglobin, ferritin,
help with RLS symptoms . serum iron, total iron-binding capacity [TIBC], calcium,
[4]
phosphorus, Ca × P product, intact parathyroid hormone
2. Methods [i-PTH], and C-reactive protein [CRP], β2-MG) in the two
groups with or without RLS.
2.1. Participants
From September 2012 to September 2017, 286 patients 2.2.2. International Restless Legs Syndrome Study
with end-stage renal disease (ESRD) on maintenance Group (IRLSSG) criteria for the diagnosis of RLS
hemodialysis participated in our research at the The RLS patients were diagnosed according to the criteria
Affiliated Hospital of Weifang Medical University. The of the IRLSSG [9,10] . The four minimal criteria include: (i)
Ethics Committee approved the protocol for the study Urge to move the legs, usually accompanied or caused
of Weifang Medical University’s Affiliated Hospital by uncomfortable leg sensations; (ii) temporary relief
(wyfy-2022-ky-183), and all subjects provided informed with movement, partial or total relief from discomfort
consent. Inclusion criteria of the present study are as follows: by walking or stretching; (iii) onset or worsening of
(i) Patients aged from 18 years to 80 years; (ii) those who symptoms at rest or inactivity, such as when lying down
met the diagnostic criteria for chronic renal failure with or sitting; and (iv) an aggravation or onset of symptoms in
uremia; (iii) those who received maintenance hemodialysis the evening or at night. To assess the severity of RLS, we
3 times/week, 4 h per time and for a period of over used the IRLSSG severity scale. Severity classification is as
3 months; (iv) those who used the same hemodialysis and follows: Mild (1 – 10 points), moderate (11 – 20 points),
dialysis; and (v) those who were in stable condition during severe (21 – 30 points), and very severe (31 – 40 points).

Volume 2 Issue 1 (2023) 2 https://doi.org/10.36922/an.210