Molnar Miklos Zsolt, Novak Marta, Szeifert Lilla, Ambrus Csaba, Keszei Andras, Koczy Agnes, Lindner Anett, Barotfi Szabolcs, Szentkiralyi Andras, Remport Adam, Mucsi Istvan
Institute of Behavioral Sciences, Fresenius Medical Care Dialysis Center, and 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
J Psychosom Res. 2007 Dec;63(6):591-7. doi: 10.1016/j.jpsychores.2007.06.007.
Restless legs syndrome (RLS) is associated with insomnia and impaired quality of life (QoL) in patients on maintenance dialysis; however, no information has been published on the association of RLS and QoL in kidney-transplanted patients. In a cross-sectional study, we analyzed the complex relationship between RLS, insomnia, and health-related QoL in kidney-transplanted patients.
In a cross-sectional survey at a single transplant center, 1067 patients were invited to participate. Complete data set was available from 785 kidney-transplanted patients. The RLS Questionnaire and the Athens Insomnia Scale were used to assess the prevalence of RLS and insomnia, respectively. QoL was measured using the Kidney Disease QoL-SF Questionnaire.
Patients with RLS were three times more likely to have insomnia than patients without RLS (29% vs. 9%, P=.001), and the presence of RLS was a significant and independent predictor of insomnia in multivariate analysis. The presence of RLS was independently associated with impaired health-related QoL along several QoL domains after statistical adjustment for clinical and sociodemographic covariables. Importantly, this association remained significant even after adjusting for insomnia for some QoL domains.
RLS is associated with poor sleep, increased odds for insomnia, and impaired QoL in kidney-transplanted patients. Our results suggest that both sleep-related and sleep-independent factors may contribute to the association of RLS and QoL.
不宁腿综合征（RLS）与维持性透析患者的失眠及生活质量（QoL）受损相关；然而，关于肾移植患者中RLS与QoL的关联尚无相关信息发表。在一项横断面研究中，我们分析了肾移植患者中RLS、失眠与健康相关QoL之间的复杂关系。
在一个单一移植中心进行的横断面调查中，邀请了1067名患者参与。785名肾移植患者有完整的数据集。分别使用RLS问卷和雅典失眠量表评估RLS和失眠的患病率。使用肾脏病生活质量简表问卷测量QoL。
RLS患者出现失眠的可能性是无RLS患者的三倍（29%对9%，P = 0.001），在多变量分析中，RLS的存在是失眠的显著且独立预测因素。在对临床和社会人口统计学协变量进行统计调整后，RLS的存在与多个QoL领域中与健康相关的QoL受损独立相关。重要的是，即使在对某些QoL领域的失眠进行调整后，这种关联仍然显著。
RLS与肾移植患者睡眠不佳、失眠几率增加及QoL受损相关。我们的结果表明，与睡眠相关和与睡眠无关的因素可能都导致了RLS与QoL的关联。
