Medications associated with restless legs syndrome: a case-control study in the US Renal Data System (USRDS)
Medications associated with restless legs syndrome: a case-control study in the US Renal Data System (USRDS)
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DOI：
10.1016/j.sleep.2014.05.011
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发表时间：
2014-10-01
期刊：
影响因子：
4.8
通讯作者：
Kutner, Nancy G.
中科院分区：
文献类型：
--
作者：
Bliwise, Donald L.;Zhang, Rebecca H.;Kutner, Nancy G.
目的：本研究的目的是确定在美国肾脏数据系统(USRDS)内的透析患者中，使用四类“危险”药物(抗抑郁药、抗精神病药、抗组胺药和具有多巴胺阻滞剂的止吐药)与不宁腿综合征(RLS)之间的关系。方法：这是一项病例对照设计，研究对象是2006年10月1日至2010年12月31日期间美国肾脏数据系统(USRDS)中所有终末期肾病(ESRD)患者登记的所有患者。共有16,165名ESRD患者(3234例；12,931名年龄、性别和种族匹配的对照组)进行了研究。结果：在USRDS的患者中，所有四类“危险”药物都得到了广泛使用。所有这些都与观察期间诊断为类风湿关节炎的几率增加有关(优势比范围为1.47-2.28；均为P<；0.0001)。在控制血液透析时间的情况下，结果没有变化。多种药物的使用增加了RLS的风险。结论：ESRD患者经常接受旨在缓解与其疾病相关的疾病的药物，如抑郁和心理问题、瘙痒和胃瘫；然而，此类药物可能增加RLS的风险。鉴于RLS在终末期肾病患者中的高患病率，只有当它们的益处明显超过RLS令人不安和痛苦症状的发展风险时，才应使用这些药物。(C)2014爱思唯尔B.V.保留所有权利。
Objective: The objective of this study was to determine the association between the usage of four classes of "at-risk" medications (antidepressants, neuroleptics, antihistamines, and antiemetics with dopamine blockade) and restless legs syndrome (RLS) in dialysis patients within the United States Renal Data System (USRDS).Methods: This was a case-control design within a national (United States) patient registry of all patients with end-stage renal disease (ESRD) in the USRDS anytime during the period of 1 October 2006 to 31 December 2010, inclusive. A total of 16,165 ESRD patients (3234 cases; 12,931 age-, sex-, and race-matched controls) were studied.Results: All four classes of "at-risk" medications see widespread use among patients in the USRDS. All were associated with increased odds of an RLS diagnosis (range of odds ratios, 1.47-2.28; all p < 0.0001) during the period of observation. Results were unchanged when controlling for time on hemodialysis. Usage of more than one class of medication increased the odds for having RLS.Conclusions: ESRD patients often receive medication intended for relief of conditions associated with their disease, such as depression and psychological issues, pruritus, and gastroparesis; however, such medications may increase the risk of RLS. Given the high prevalence of RLS in ESRD patients, these medications should only be used when their benefits clearly outweigh the risk of development of the troubling and distressing symptoms of RLS. (C) 2014 Elsevier B. V. All rights reserved.