Azar S A, Hatefi R, Talebi M
Transplantation Ward, Imam Khomeini Hospital, Tabriz University, IRAN Tabriz, Iran.
Transplant Proc. 2007 May;39(4):1132-3. doi: 10.1016/j.transproceed.2007.03.097.
Restless legs syndrome (RLS) is a common cause of sleep disturbance frequently experienced by hemodialysis patients. It is a neurological movement disorder. Patients with RLS suffer an irresistible urge to move the legs during inactivity with relief by motion and various activities.
We investigated the clinical course of RLS in 30 (12 female and 18 male) hemodialysis patients with mean dialysis duration of 16.8 +/- 14.13 months who underwent kidney transplantation. Patients were given a standardized questionnaire evaluating details of RLS at baseline and twice after kidney transplantation. They were diagnosed to have RLS by International RLS Study Group criteria. Biochemical (serum calcium, phosphate, Na, and K and blood urea and creatinine) and hematological indices (serum iron, hemoglobin) were measured at each time.
RLS in hemodialysis patients was significantly reduced by renal transplantation (43.3%; P<.0001). There was a significant association between RLS and lower serum iron (P<.01) and phosphorus (P<.02) after renal transplantation: We did not observe any association between hemoglobin levels, age, sex, dialysis duration, and time after transplantation with RLS.
Kidney transplantation showed a strong, positive influence on RLS symptoms in hemodialysis patients. Correction of serum phosphate and serum iron (by mechanisms different than its effect on hemoglobin) can affect RLS in kidney transplant patients.
不宁腿综合征(RLS)是血液透析患者经常经历的睡眠障碍的常见原因。它是一种神经运动障碍。RLS患者在不活动时会有难以抑制的腿部活动冲动,通过活动及各种行为可缓解。
我们调查了30例(12例女性和18例男性)接受肾移植的血液透析患者的RLS临床病程,这些患者的平均透析时间为16.8±14.13个月。患者在基线时以及肾移植后两次接受标准化问卷,评估RLS的详细情况。根据国际RLS研究组标准诊断他们患有RLS。每次测量生化指标(血清钙、磷、钠、钾以及血尿素和肌酐)和血液学指标(血清铁、血红蛋白)。
肾移植使血液透析患者的RLS显著减轻(43.3%;P<0.0001)。肾移植后RLS与较低的血清铁(P<0.01)和磷(P<0.02)之间存在显著关联:我们未观察到血红蛋白水平、年龄、性别、透析时间以及移植后时间与RLS之间存在任何关联。
肾移植对血液透析患者的RLS症状有强烈且积极的影响。纠正血清磷和血清铁(通过不同于其对血红蛋白影响的机制)可影响肾移植患者的RLS。