| Objective: To investigate the prevalenceof restless leg syndrome(RLS)in patients on maintenance hemodialysis(HD)and peritoneal dialysis(PD),to analyze the associated factors of RLS in both HD and PD patients,to enquire the pathogenesis of hemodialysis and peritoneal dialysis patients with restless legs syndrome,and to guide the clinical treatment.Methods: We studied the patients of the second affiliated hospital of Dalian Medical University who were onregular hemodialysis and peritoneal dialysis for a duration at least 6 months in the period of December 2014 till December 2015.The requirements of this survey were as follows: age of 18 to 80 years,willingness to participate in the study.The exclusion criteria are the following: the presence of any recent infection,presence of cancer,drug or alcohol dependence,hormone or immunosuppressive therapy,patients havingcardiovascular,respiratory and liver diseases,patients with Parkinson's disease and other neurological diseases,those who have recently received intravenous iron therapy,reluctance to participate in the study,patients with whom a good communication could not be establishe d,pregnancy and the patients who had been diagnosed of RLS before dialysis treatment.We interviewed the patients and collected the following information: gender,age,primary disease leading to ESRD,family history,personal habits,medication status,the type ofdialysis,dialysis duration,and the daily urine volume in CAPD patients,the volume ultrafiltrate of CAPD patients in one session and the blood and urine results before dialysis.Using the Restless Leg Syndrome questionnairewe have classified the patients with RLS according to their respective severities.The HD and PD patients were categorized into two groups based on the presence and absence of RLS and their respective data were compared.Then multivariate logistic analysis was used to analyse the data.The diagnosis of RLS rely on the diagnostic criteria for RLS revised by the international restless legs syndrome research group in 2003 and the severity of RLS was divided into mild,moderate,severe,and very severe according to the classification published in 2003.Results: 1.A total of 115 HD and 102 PD patients were enrolled in this study.39 HD patients and 17 PD patients were diagnosed with RLS.2.The prevalence of RLS was 33.9% in HD patients and 16.7% in PD patients.3.The HD patients with RLS had higher iPTH(480.82±343.91vs352.50±302.32 pg/m L,P=0.047),vitamin B12(794.90±241.19vs660.80±249.34 pg/mL,P=0.039),and total protein level(69.70±7.03vs66.40±7.16 g/L,P=0.021)compared to those without RLS.HD patients with very severe RLS had higher vitamin B12 than those with moderate RLS(937.35±228.22vs707.44±115.6 pg/m L,P=0.030).No significant difference in gender,age,type of dialysis,duration of dialysis,hemoglobin level,white blood cell count,neutrophil percentage,predialysis blood urea nitrogen,creatinine,uric acid,CRP,calcium,magnesium,serum phosphate,ferritin,transferrin saturation,thyroid hormone,folic acid and presence of diabetes mellitus was found in HD and PD patients,with and without RLS.4.There was also no significant difference in the serum iPTH level,vitamin B12 and total protein levels in PD patients,with or without RLS.5.The HD patients with RLS had higher iPTH(480.82±343.91vs257.8±159.46 pg/m L,P=0.002)and serum phosphate level(2.12±0.72vs1.58±0.37 mmol/L,P<0.0001)compared to PD patients with RLS.6.The multivariate logistic regression analysis showed that high total protein level(OR:1.042,95%CI(0.968-1.121),P=0.037)was a risk factor of RLS and high vitamin B12(OR:1.002,95%CI(1.000-1.004),P=0.040)was an independent risk factor of RLS in HD patients.Conclusions: The prevalence of RLS in HD patients of our hospital was 33.9%.The prevalence of RLS in PD patients of our hospital was 16.7%.The HD patients with RLS had higher PTH compared to those without RLS.High total protein level was a risk factor of RLS and high vitamin B12 was an independent risk factor of RLS in HD patients. |
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