A Multicenter Clinical Study Of Uremia Restless Leg Syndrome And Its Related Factors

Research objectives:1.To investigate the incidence of uremic restless legs syndrome in patients with chronic kidney disease in three research centers in the region,and to evaluate the overall incidence of uremic restless legs syndrome in Chengdu,Sichuan Province;2.To explore the differences in the incidence and clinical characteristics of uremic restless legs syndrome among different dialysis methods;3.To explore the differences in the incidence and clinical characteristics of uremic restless legs syndrome in patients with chronic kidney disease at different stages;4.To analyze the related factors of uremic patients with restless legs syndrome to provide some guidance for clinical treatment.Materials and Methods:According to the inclusion and exclusion criteria,a total of 542 hemodialysis patients(2 3 8 patients from the First Affiliated Hospital of Chengdu Medical College,1 8 7 patients from Xinhua Hospital Affiliated to North Sichuan Medical College,and 1 1patients from Nuclear Industry 4 1 6 Hospital),1 1 6 peritoneal dialysis patients(patients from the First Affiliated Hospital of Chengdu Medical College)and 1 1 6 peritoneal dialysis patients were collected 4 4 2 non-dialysis patients with chronic kidney disease(3 4 6 outpatients from the Department of Nephrology of the First Affiliated Hospital of Chengdu Medical College and 9 6 outpatients from Xinhua Hospital affiliated to North Sichuan Medical College).The patients’ social demographic data,laboratory indicators,treatment and other data were collected.The RLS/ WELS(IRLS)severity rating scale and IRLSSG restless legs syndrome(RLS)severity self-rating scale were used to assess the severity of uremic restless legs syndrome.SPSS2 6.0 software was used to analyze the data.The measurement data consistent with normal distribution were expressed as ± s,and the comparison between groups was analyzed by independent sample t test.The measurement data not consistent with normal distribution were expressed as M(1/4,3/4),and the comparison between the two groups was analyzed by Mann-Whitney U test.Finally,Chi-square test was used to compare the count data,the variables were included in the univariate Logistic regression model to screen suspicious factors,and then the suspicious factors were included in the multivariate Logistic regression model to determine the relevant risk factors.Results:1.A total of 5 4 2 hemodialysis patients met the inclusion criteria,aged from 2 0 to8 5 years,with an average age of 61.46± 14.06 years.There were 319 males(59.8 %),with an average age of 60.90± 14.02 years,and 223 females(41.1%),with an average age of 62.56± 14.40 years.63 patients(11.6%)developed uremic restless legs syndrome.According to the RLS/WELS(IRLS)severity rating scale,3 0 cases(5.5 %)were episodic,5 cases(0.9%)were transient,4 cases(0.7%)were relapsed-remitting and 27cases(4.4 %)were persistent.IRLSSG restless legs syndrome(RLS)severity self-rating scale severity grouping: very severe: 1 case(0.1%),severe 7 cases(1.2%),moderate 12cases(2.2%),mild 39 cases(7.1%),no discomfort 4 cases(0.7%).Among them,15cases(2.7%)of uremic restless legs syndrome were treated with drugs.2.A total of 116 peritoneal dialysis patients,aged from 25 to 85 years,including 62males(53.4%)with an average age of(49.98± 14.16)years and 54 females(46.5%)with an average age of(51.50± 13.18)years,were enrolled in this study.The incidence was1 4.6%.According to the RLS/WELS(IRLS)severity rating scale,6 cases(5.1%)were episodic,2 cases(1.7 %)were transient,3 cases(2.5 %)were relapsing and remitting,and 6 cases(5.1 %)were persistent.The severity of restless legs syndrome(RLS)in IRLSSG was very severe in 2 cases(1.7 %),severe in 4 cases(3.4 %),moderate in 3cases(2.5%),mild in 8 cases(6.8%).Among them,Five cases(4.3%)of uremic restless legs syndrome were treated with drugs.3.4 4 2 non-dialysis patients with chronic kidney disease who met the inclusion criteria,aged from 25 to 85 years,including 230 males(52.0%)with an average age of(62.20± 14.54)years,212 females(47.9%)with an average age of(62.50± 13.94)years,and 5 patients with uremic restless legs syndrome.The incidence was 1.1 %.According to the RLS/WELS(IRLS)severity rating scale,there were 2 cases(0.4%)of episodic,1case(0.2%)of relapse-remitting and 2 cases(0.4%)of persistent.The severity of restless legs syndrome(RLS)self-rating scale of IRLSSG was severe in 1 case(0.2 %),moderate in 2 cases(0.4%),and mild in 2 cases(0.4%).Among them,there was no drug treatment for uremic restless legs syndrome.4.Pruritus,dialysis mode,high density lipoprotein cholesterol(HDLC)in hemodialysis patients have a certain correlation with the incidence of restless legs syndrome(p < 0.0 5).Diabetes and pruritus were independent risk factors for uremic restless legs syndrome(p < 0.05).The duration of dialysis and total Ccr in peritoneal dialysis patients were correlated with the incidence of restless legs syndrome(p < 0.05).Pruritus,lymphocyte percentage(LY%)and peritoneal dialysate protein were independent risk factors for uremic restless legs syndrome(p < 0.05).6.There was a certain correlation between diabetes mellitus and triglyceride(TG)in dialysis patients,with statistical significance(p < 0.0 5).Pruritus,anxiety and URIC acid were independent risk factors for restless legs syndrome(p < 0.05).7.CREA in non-dialysis patients was an independent risk factor for u RLS(p <0.05)Conclusions:1.The incidence of uremic restless legs syndrome was 1 1.6 % in hemodialysis patients and 1 4.6 % in peritoneal dialysis patients in Chengdu area of Sichuan Province.The incidence of uremic restless legs syndrome was 1 2.1 % in total dialysis population and 1.1% in non-dialysis patients with chronic kidney disease.2.Diabetes,pruritus and dialysis frequency(low frequency)are independent risk factors for uremic restless legs syndrome in hemodialysis patients.(3)The history of pruritus,hypertension,lymphocyte percentage(LY%)and peritoneal dialysate protein are independent risk factors for uremic restless legs syndrome in peritoneal dialysis patients.(4)Pruritus,anxiety and uric acid are independent risk factors for u RLS in hemodialysis patients.(5)Creatinine in non-dialysis patients is the only independent risk factor for u RLS.