Survival of Dialysis Patients with Restless Legs Syndrome: A 15-Year Follow-Up Study

2017 ◽  
Vol 46 (3) ◽  
pp. 224-230 ◽  
Author(s):  
Simone Baiardi ◽  
Susanna Mondini ◽  
Alessandro Baldi Antognini ◽  
Antonio Santoro ◽  
Fabio Cirignotta
Keyword(s):  
Mortality Rate ◽  
Restless Legs Syndrome ◽  
Rank Test ◽  
Control Group ◽  
Dialysis Patients ◽  
Restless Legs ◽  
Cardiovascular Morbidity And Mortality ◽  
Uremic Patients ◽  
Esrd Patients

Background: Restless legs syndrome, also known as Willis/Ekbom disease (RLS/WED), is a sleep-related, sensorimotor disorder with a high prevalence among end-stage renal disease (ESRD) patients undergoing haemodialysis (HD) (about 15-40%). Whether RLS/WED in uremic patients influences cardiovascular morbidity and mortality remains a matter of controversy. The aim of this study was to evaluate the relationship of RLS/WED and mortality in a population of chronically dialyzed patients. Method: In 1996, we studied 128 patients with ESRD undergoing HD; 47 subjects (36.7%) complained RLS/WED symptoms. Fifteen years later we evaluated the mortality of this population. No clinical follow-up examination of the uremic population was made. The Kaplan-Maier curves in dialysis patients with or without RLS/WED (control group matched for age) were constructed for all-cause mortality and compared using log-rank test. Results: The Kaplan-Maier curves disclosed a lower mortality rate in the uremic patients with RLS/WED than in those without RLS/WED (p = 0.04). In our analysis, the mortality rate was not influenced by RLS/WED severity (p = 0.11) or gender (p = 0.15). No difference among the causes of death was found in the 2 groups. Conclusions: Our study suggests that mortality in ESRD patients is not influenced by concomitant RLS/WED. After a 15-year follow-up, survival rates in our cohort were significantly longer in uremic subjects with RLS/WED than in those without RLS/WED. Finally, we found no relationship between RLS/WED severity and mortality.

scholarly journals Time evolution of restless legs syndrome in haemodialysis patients

2019 ◽  
Author(s):  
Irene Capelli ◽  
Fabio Pizza ◽  
Marco Ruggeri ◽  
Lorenzo Gasperoni ◽  
Elisa Carretta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Kidney Transplantation ◽  
Restless Legs Syndrome ◽  
Statistical Significance ◽  
Dialysis Patients ◽  
Restless Legs ◽  
Continuous Form ◽  
Over Time

Abstract Background Restless legs syndrome (RLS) is characterized by an urge to move the extremities, accompanied by paraesthesiae, in the evening and at night. Uraemic RLS, a type of secondary RLS, occurs commonly in chronic kidney disease and end-stage renal disease. Progression of uraemic RLS over time is unclear. Therefore we investigated the prevalence, progression over time, risk factors and impact on survival of uraemic RLS in a cohort of dialysis patients. Methods We reviewed at the 7-year follow-up a cohort of haemodialysis (HD) patients we had previously investigated for RLS, through interviews, validated questionnaires and analysis of demographic and clinical data. Results At the 7-year follow-up, RLS was present in 16% of patients, with a persistence rate of 33%. A correlation was obtained between RLS and older age, diabetes, low albumin and low body mass index. RLS was associated with reduced overall survival (median survival of 3.3 versus 3.7 years), particularly with the continuous form of RLS (1.61 years). There was a higher incidence of myocardial infarction and peripheral vascular disease, although not reaching statistical significance. RLS patients had absolute higher scores in all quality of life domains. A large majority of study patients (96%) reported being symptom-free within a few days or weeks following kidney transplantation. Conclusions The development of RLS, especially the continuous form, in patients undergoing HD has important consequences associated with decreased survival. Our results indicated an association between uraemic RLS and ageing, diabetes and malnutrition. Considerable efforts should be focused on the treatment of RLS, since it significantly and persistently impacts the quality of life of HD patients. Kidney transplantation could represent an effective treatment option for that RLS impacts on dialysis patients' quality of life, thus confirming the secondary nature of RLS in most HD patients.

Pengaruh Latihan Kekuatan terhadap Restless Legs Syndrome Pasien Hemodialisis

1970 ◽  
Vol 5 (1) ◽  
Author(s):  
Anggriyana Tri Widianti ◽  
Yanti Hermayanti ◽  
Titis Kurniawan
Keyword(s):  
Restless Legs Syndrome ◽  
Random Sampling ◽  
Control Group ◽  
Restless Legs ◽  
Post Test ◽  
Cluster Random Sampling ◽  
Scale Data

Restless legs syndrome (RLS) adalah gangguan sensorimotor yang banyak terjadi pada pasien hemodialisis (HD).Terapi farmakologi merupakan pilihan utama penanganan RLS yang justru berisiko menimbulkan efek samping.Optimalisasi fisik pasien HD melalui latihan kekuatan dinilai berpotensi efektif memperbaiki restless legs syndrome.Belum terdapat penelitian yang mengklarifikasi pengaruh latihan kekuatan terhadap RLS. Penelitian ini bertujuanuntuk mengidentifikasi pengaruh latihan kekuatan terhadap skala RLS pada pasien HD di Unit Hemodialisis di RSMargono Soekardjo dan RSUD Banyumas. Metode quasi eksperimen dengan pre-post test with control group designini menggunakan sampel sebanyak 32 pasien HD (15 pasien intervensi dan 17 pasien kontrol) dengan teknik clusterrandom sampling. Cluster random sampling dalam penelitian ini adalah penggunaan tempat penelitian sebagai kelas,yaitu satu rumah sakit untuk intervensi dan rumah sakit lainnya digunakan untuk kontrol. Latihan kekuatan padaekstremitas atas dan bawah diberikan 2 minggu sekali saat proses hemodialisis berlangsung selama 8 minggu. SkalaRLS diukur menggunakan IRLS Scale. Data yang terkumpul dianalisis menggunakan uji t tidak berpasangan. Hasilpenelitian menunjukkan bahwa tidak terdapat perbedaan antar kelompok dari usia, ureum, adekuasi, lama HD, jeniskelamin, penyakit kormobid maupun penggunaan obat. Antar kelompok memperlihatkan terdapat perbedaan nilaiTIBC (p=0,000). Skala RLS kelompok intervensi menunjukan perbaikan dengan selisih mean -1 yang menandakanpenuruan skala, adapun pada kelompok kontrol justru terlihat peningkatan kondisi RLS dengan selisih mean 1,29.Analisis antar kelompok terlihat signifikansi berbeda (p=0,035) yang menunjukkan terdapat pengaruh latihankekuatan terhadap skala RLS. Latihan kekuatan penting sebagai bagian dalam pengelolaan pasien uremik RLS.

scholarly journals Nonclonal chromosomal alterations and poor survival in cytopenic patients without hematological malignancies

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Osamu Imataki ◽  
Hiroyuki Kubo ◽  
Akihiro Takeuchi ◽  
Makiko Uemura ◽  
Norimitsu Kadowaki
Keyword(s):  
Single Cell ◽  
Chromosomal Aberration ◽  
Hematological Malignancies ◽  
Chromosomal Abnormalities ◽  
Bone Marrow Aspiration ◽  
Normal Karyotype ◽  
Rank Test ◽  
Control Group ◽  
Chromosomal Alterations

Abstract Background Clonal chromosomal alterations (CCAs) reflect recurrent genetic changes derived from a single evolving clone, whereas nonclonal chromosomal alterations (NCCAs) comprise a single or nonrecurrent chromosomal abnormality. CCAs and NCCAs in hematopoietic cells have been partially investigated in cytopenic patients without hematological malignancies. Methods This single-center retrospective study included 253 consecutive patients who underwent bone marrow aspiration to determine the cause of cytopenia between 2012 and 2015. Patients with hematological malignancies were excluded. CCA was defined as a chromosomal aberration detected in more than two cells, and NCCA was defined as a chromosomal aberration detected in a single cell. Results The median age of the patients was 66 years. There were 135 patients without hematological malignancies (median age, 64 years; 69 females); of these, 27 patients (median age, 69 years; 8 females) harbored chromosomal abnormalities. CCAs were detected in 14 patients; the most common CCA was −Y in eight patients, followed by inv.(9) in three patients and mar1+, inv. (12), and t (19;21) in one patient each. NCCAs were detected in 13 patients; the most frequent NCCA was +Y in four patients, followed by del (20), + 8, inv. (2), − 8, and add (6) in one patient each. Moreover, nonclonal translocation abnormalities, including t (9;14), t (14;16), and t (13;21), were observed in three patients. One patient had a complex karyotype in a single cell. The remaining 106 patients with normal karyotypes comprised the control group (median age, 65 years; range, 1–92 years; 56 females). Further, follow-up analysis revealed that the overall survival of the NCCA group was worse than that of the CCA and the normal karyotype groups (P < 0.0001; log-rank test). The survival of the NCCA-harboring cytopenic patients was worse than that of the CCA-harboring cytopenic patients without hematological malignancies, suggesting that follow-up should be considered for both CCA- and NCCA-harboring cytopenic patients.

scholarly journals Restless Legs Syndrome in Patients with Chronic Obstructive Pulmonary Disease

2008 ◽  
Vol 35 (3) ◽  
pp. 352-357 ◽  
Author(s):  
Yuksel Kaplan ◽  
Handan Inonu ◽  
Ayse Yilmaz ◽  
Serpil Ocal
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Restless Legs Syndrome ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Similar Frequency ◽  
Restless Legs ◽  
Copd Patients ◽  
Group 1

Objective:To evaluate the prevalence of restless legs syndrome (RLS) in patients with chronic obstructive pulmonary disease (COPD) and the relationship between RLS and clinical/laboratory findings of COPD.Methods:One hundred and thirty-four COPD patients without secondary causes of RLS were included. Thirty-nine (29.1%) patients were diagnosed with RLS and classified as Group 1. The control group consisted of 65 age-matched COPD patients without RLS. Group 1 was divided into subgroups according to the Johns Hopkins Severity (JHS) scale. Patients with a score of 0, 1, or 2 were classified as JHS 0-2 and those with a score of 3 as JHS 3. Group 1 and the control group and subgroups were compared for clinical and laboratory characteristics.Results:We found that the duration of COPD was longer and that airway obstruction, hypercapnia, and hypoxia were more evident in patients with RLS than those without. Similar differences were also detected between JHS subgroups 3 (more severe) and 0-2. Polyneuropathy frequency was significantly higher in Group 1 compared to controls. However, Group 1 subgroups showed a similar frequency of polyneuropathy. In a multivariate analysis, hypercapnia made a significant independent contribution to both JHS 0-2 and JHS 3 patients when RLS severity was set as the dependent variable. Polyneuropathy and the duration of COPD were significant independent variables for patients in the JHS 3 subgroup. Polyneuropathy was the strongest predictor for the JHS 3 patients.Conclusions:We conclude that RLS is frequent in COPD, particularly in patients with severe hypoxemia/hypercapnia and in late stages of the disease.

Clinical management of restless legs syndrome in end-stage renal disease patients

CNS Spectrums ◽  
2016 ◽  
Vol 22 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Zeyad T. Sahli ◽  
Jae Jo ◽  
Shaker A. Mousa ◽  
Frank I. Tarazi
Keyword(s):  
Renal Disease ◽  
Restless Legs Syndrome ◽  
End Stage Renal Disease ◽  
Treatment Guidelines ◽  
Small Sample ◽  
Limited Information ◽  
Restless Legs ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Restless legs syndrome (RLS) is a common neurological movement disorder, characterized by restless and unpleasant sensations in the deep inside of legs. The symptoms of RLS are less noticeable during daytime, but more prevalent at night. Therefore, the disorder can induce low quality of life, insomnia, and impairment of daytime activity. RLS in end-stage renal disease (ESRD) patients is especially problematic due to premature discontinuation of dialysis and increased mortality. The prevalence of RLS among dialysis patients is much higher compared to the prevalence of the same disorder in patients with normal renal functions. Even though there are recommended treatment guidelines for the general population established by Medical Advisory Board of the RLS foundation, which include the use of dopamine agonists, levodopa, gabapentin, benzodiazepines, and opioids, limited information is available on the effects of these therapies in ESRD patients. Since the existing clinical data were extrapolated from small sample sizes in short-term clinical trials, further clinical studies are still needed to better assess the efficacy, safety, and tolerability of these medications in patients with ESRD.

Restless legs syndrome in dialysis patients: a meta-analysis

2014 ◽  
Vol 15 (12) ◽  
pp. 1532-1538 ◽  
Author(s):  
Song Mao ◽  
Hua Shen ◽  
Songming Huang ◽  
Aihua Zhang
Keyword(s):  
Restless Legs Syndrome ◽  
Meta Analysis ◽  
Dialysis Patients ◽  
Restless Legs

Influence of Chemotherapy Within 30 Days Before ICU Admission on Mortality in Critically Ill Medical Patients With Cancer

2017 ◽  
Vol 34 (9) ◽  
pp. 732-739
Author(s):  
Ricardo Calderón-Pelayo ◽  
Pilar León ◽  
Pablo Monedero ◽  
Pilar Calderón-Breñosa ◽  
Marc Vives ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Mortality Rate ◽  
Organ Failure ◽  
Cox Regression ◽  
Group Versus ◽  
Rank Test ◽  
Control Group ◽  
Medical Patients ◽  
Icu Admission ◽  
Patients With Cancer

Background: The main objective was to determine whether the administration of chemotherapy (CT) during the month before intensive care unit (ICU) admission of medical patients with cancer influences the survival rate. The design was a single-institution observational cohort study in an ICU of a tertiary university hospital. Methods: Our cohort included 248 oncology patients admitted to the ICU from 2005 to 2014 due to nonsurgical problems. Seventy-six (30.6%) patients had received CT in the month before admission (CT group) and 172 did not receive CT (control group). The main outcome measures were ICU, hospital, 30-day, 90-day, and 1-year mortalities. We performed survival analysis using the Kaplan-Meier estimator, comparing both groups using the log-rank test, and multivariate analysis using Cox regression adjusted for gender, age, maximum Sequential Organ Failure Assessment (SOFA), and delta maximum SOFA to calculate the hazard ratios (HRs) and their respective 95% confidence intervals. This association was also evaluated by a graphic representation of survival. Results: The CT group presented an ICU mortality rate of 27.6% versus 25.5% in the control group. The multivariate analysis adjusted for age, sex, and delta maximum SOFA showed significant differences between the groups (HR: 2.12; P = .009). The hospital mortality rate was 55.3% in the CT group compared to 45.4% in the control group (adjusted HR: 1.81; P = .003). At 30 days, the mortality rate was 56.6% in the CT group compared to 46.5% in the control group (adjusted HR: 1.69; P = .008). Mortality at 90 days was 65.8% in the CT group versus 59.9% in the control group (adjusted HR: 1.47; P = .03). One-year mortality was also higher in the CT group (79% vs 72.7%, adjusted HR: 1.44; P = .02). Conclusion: The administration of CT in the month before ICU admission in patients with cancer was associated with higher mortality in the ICU, in the hospital, and 30 and 90 days after admission when adjusted for the increase in organ failure measured by delta maximum SOFA. We provide useful new information for decision-making about ICU management of patients with cancer.

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