Restless legs syndrome enhances cardiovascular risk and mortality in patients with end-stage kidney disease undergoing long-term haemodialysis treatment
Restless legs syndrome enhances cardiovascular risk and mortality in patients with end-stage kidney disease undergoing long-term haemodialysis treatment
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DOI：
10.1093/ndt/gfq681
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发表时间：
2011-06-01
影响因子：
6.1
通讯作者：
Stefoni, Sergio
中科院分区：
文献类型：
--
作者：
La Manna, Gaetano;Pizza, Fabio;Stefoni, Sergio
背景不宁腿综合征（RLS）是一种感觉运动神经系统疾病，其特征是感觉异常、感觉迟钝和不可抗拒的冲动，特别是在夜间。透析患者的患病率更高，为12 - 62%，而普通人群为3 - 9%。在此，我们调查了终末期肾病（ESKD）透析患者RLS与心血管事件风险和实验室参数之间的关系。100例接受血液透析的ESKD患者入组了一项为期18个月的前瞻性观察性研究。主要结果是RLS与新发心血管事件和心血管死亡率的关系。RLS影响了31%的研究人群。其与女性性别、残余多尿逐渐减少、低白蛋白（P = 0.039）和炎症相关，但与透析参数Kt/V和URR无关。在观察期间，47%的患者发生了新的心血管事件（64.5%伴RLS，39.1%不伴RLS; P = 0.019）。新发心血管事件随着RLS严重程度的增加而增加[间歇性（I-RLS）vs连续性（C-RLS）]。所有患者的死亡率为20.0%，有RLS的患者为32.3%，无RLS的患者为14.5%（P = 0.04）。I-RLS患者的死亡率为23.8%，而C-RLS患者的死亡率为55.6%（P = 0.014）。多因素分析证实了RLS与死亡率的关系。这项研究证实了RLS在透析患者中的高患病率，以及RLS严重程度与新发心血管事件风险和较高短期死亡率之间的相关性。
Background. Restless legs syndrome (RLS) is a sensorimotor neurological disorder characterized by paraesthesia, dysaesthesia and the irresistible urge to move the legs especially at night. Its prevalence is much higher among dialysis patients at 12 to 62% compared to 3 to 9% in the general population. Here, we investigated the association between RLS and cardiovascular events risk and laboratory parameters in end-stage kidney disease (ESKD) patients on dialysis.Methods. One hundred ESKD patients undergoing haemodialysis were enrolled in an 18-month prospective observational study. The main outcomes were the associations of RLS with new cardiovascular events and cardiovascular mortality.Results. RLS affected 31% of the study population. It was associated with female gender, gradual reduction in residual diuresis, lower albumin (P = 0.039) and inflammation, but not the dialysis parameters Kt/V and URR. During observation, 47% of patients experienced new cardiovascular events (64.5% with and 39.1% without RLS; P = 0.019). New cardiovascular events increased with severity of RLS [intermittent (I-RLS) vs continuous (C-RLS)]. Mortality was 20.0% in all patients, 32.3% in those with and 14.5% in patients without RLS (P = 0.04). In patients with I-RLS, mortality was 23.8% compared to 55.6% in patients with C-RLS (P = 0.014). Multivariate analysis confirmed the relationship between RLS and mortality.Conclusions. This study confirmed the high prevalence of RLS among dialysis patients and the associations between the severity of RLS and the risk of new cardiovascular events and higher short-term mortality.