Effect of Mineral and Bone Metabolism on Restless Legs Syndrome in Hemodialysis Patients
Autor: | Ramaiane A. Bridi, Ivone B. Oliveira, Rosa M.A. Moysés, Rosilene M. Elias, Precil Diego Miranda de Menezes Neves, Fabiana G. Graciolli |
---|---|
Rok vydání: | 2017 |
Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology Disease Severity of Illness Index Bone remodeling 03 medical and health sciences 0302 clinical medicine Renal Dialysis Restless Legs Syndrome Internal medicine mental disorders Humans Medicine Restless legs syndrome Renal Insufficiency Chronic Dialysis Chronic Kidney Disease-Mineral and Bone Disorder Minerals biology business.industry Middle Aged medicine.disease Scientific Investigations Pathophysiology Clinical neurology Surgery body regions Ferritin Fibroblast Growth Factor-23 Neurology biology.protein Female Neurology (clinical) Hemodialysis business 030217 neurology & neurosurgery |
Zdroj: | Journal of Clinical Sleep Medicine. 13:89-94 |
ISSN: | 1550-9397 1550-9389 |
Popis: | Restless legs syndrome (RLS) is a highly prevalent sleep disease among patients on hemodialysis. The physiopathology is still unclear, and may be multifactorial. Because of the association between iron metabolism and chronic kidney disease-mineral and bone disorders (CKD-MBD), we hypothesized that both factors would be associated with RLS.We have evaluated hemodialysis patients, in a face-to-face interview for the diagnosis and severity of RLS, as measured by the International Restless Legs Syndrome Study Group. Clinical, demographic, and biochemical characteristics were measured.Out of 101 adult patients included, RLS was found in 29 (28.7%). Adjusted multinomial regression analysis revealed that age older than 35 years, transferrin saturation less than 47%, serum ferritin level less than 700 ng/mL, hemoglobin level less than 9.8 g/dL, serum phosphate level higher than 5.2 mg/dL, FGF-23 higher than 2,000 RU/mL, and C-reactive protein less than 1.24 mg/dL were independently associated with RLS. RLS was classified as mild, moderate, severe, and very severe in 3.4%, 41.7%, 44.8%, and 10.1% of patients, respectively. Scores of severity correlated significantly with erythropoietin dose/kg/w (p = 0.046), phosphate (p = 0.003), and inversely with serum albumin (p = 0.003) and calcium (p = 0.008). Phosphate and 25(OH)-vitamin D correlated with transferrin saturation. Patients with severe/very severe symptoms were mostly women, presented with lower serum iron, ionic calcium, and serum albumin levels and higher levels of serum phosphate, and higher percentage of 25(OH)-vitamin D deficiency and levels of FGF-23 higher than 2,000 RU/mL than did those with mild/moderate symptoms.CKD-MBD factors besides iron metabolism are associated with RLS in patients on hemodialysis, providing new insights into the understanding of RLS in this population. |
Databáze: | OpenAIRE |
Externí odkaz: |