Department of Neurosciences, Sleep Disorders Center, Santa Maria della Misericordia University Hospital, Udine, Italy.
Mov Disord. 2010 Jun 15;25(8):1019-25. doi: 10.1002/mds.23010.
Restless legs syndrome (RLS) is a possible consequence of end-stage renal disease. However, conclusive data on the association between RLS and chronic renal failure (CRF) in nondialyzed patients are still lacking. The aims of this study were: (1) to look for an association between RLS and CRF in nondialyzed patients; (2) to analyze the characteristics of RLS and its consequences on nocturnal rest in nondialyzed patients with CRF; (3) to identify possible predictors of RLS occurrence in nondialyzed patients with CRF. We recruited 138 nondialyzed patients with CRF (mean age: 69.8 +/- 11.7 years; male: 61.6%) and 151 controls (mean age: 60.2 +/- 18.6 years; male: 42.4%). An expert in sleep medicine investigated the presence of RLS by means of a face-to-face interview. Fifteen nondialyzed CRF patients and five controls were diagnosed as RLS affected. A multivariate analysis confirmed that RLS was independently associated with CRF in nondialyzed patients (P = 0.004). CRF patients RLS(+) were more commonly women and showed the presence of an iron deficiency compared with the RLS(-) ones. Independent predictors of RLS in nondialyzed CRF patients were: female sex (OR: 10.7, 95% CI: 2.2-31.3; P = 0.004) and percentage of transferrin saturation (OR: 0.6, 95% CI: 0.4-0.9; P = 0.04). This is the first case-control study able to recognize an association between RLS and CRF in patients not yet on dialysis. Nephrologists should investigate and treat RLS in their nondialyzed patients with CRF. In particular, physicians should carefully investigate women and patients with iron deficiency in the presence of RLS symptoms.
不透析的慢性肾衰竭患者中不安腿综合征与慢性肾衰竭的关系
不安腿综合征（RLS）是终末期肾病的一种可能后果。然而，在未透析的患者中，RLS 与慢性肾衰竭（CRF）之间的关联仍缺乏确凿的数据。本研究的目的是：（1）在未透析的患者中寻找 RLS 与 CRF 之间的关联；（2）分析 RLS 的特征及其对 CRF 未透析患者夜间休息的影响；（3）确定 CRF 未透析患者 RLS 发生的可能预测因素。我们招募了 138 名未透析的 CRF 患者（平均年龄：69.8 +/- 11.7 岁；男性：61.6%）和 151 名对照者（平均年龄：60.2 +/- 18.6 岁；男性：42.4%）。一位睡眠医学专家通过面对面的访谈调查了 RLS 的存在。15 名未透析的 CRF 患者和 5 名对照者被诊断为 RLS 受影响者。多变量分析证实，RLS 与未透析的 CRF 患者独立相关（P = 0.004）。与 RLS（-）患者相比，CRF 患者 RLS（+）中更多的是女性，并且存在铁缺乏症。未透析的 CRF 患者 RLS 的独立预测因素是：女性（OR：10.7，95%CI：2.2-31.3；P = 0.004）和转铁蛋白饱和度的百分比（OR：0.6，95%CI：0.4-0.9；P = 0.04）。这是第一项能够在未透析的患者中识别 RLS 与 CRF 之间关联的病例对照研究。肾病学家应在患有 CRF 的未透析患者中调查和治疗 RLS。特别是，医生应在出现 RLS 症状时仔细调查女性和铁缺乏症患者。
