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接受血液透析的终末期肾病患者的不宁腿综合征

Restless legs syndrome in end stage renal disease patients undergoing hemodialysis.

作者信息

Lin Xiao-Wei, Zhang Jun-Fang, Qiu Meng-Yao, Ni Ling-Yan, Yu Hong-Lei, Kuo Sheng-Han, Ondo William G, Yu Qing, Wu Yun-Cheng

机构信息

Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People's Republic of China.

Department of Nephrology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People's Republic of China.

出版信息

BMC Neurol. 2019 Mar 29;19(1):47. doi: 10.1186/s12883-019-1265-y.

Abstract

BACKGROUND

The prevalence of Restless legs syndrome (RLS) in End Stage Renal Disease (ESRD) patients is higher than that in the general population. However, the associations of RLS within the ESRD population are inconsistent and RLS is usually neglected in dialysis centers, although it impairs the life quality among ESRD patients. We aim to investigate the prevalence of RLS in patients with ESRD undergoing maintenance hemodialysis and evaluate the risk factors of developing RLS and the effect of RLS on quality of life among ESRD patients.

METHODS

ESRD patients undergoing maintenance hemodialysis in Shanghai General Hospital dialysis unit from July 2016 to October 2016 were enrolled in the study. RLS was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group (IRLSSG). IRLSSG Severity Scale was used to evaluate the severity of RLS. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and Hospital Anxiety and Depression Scale (HADS) was used to estimate anxiety and depression. Serologic and historic variables were analyzed to determine predictors of RLS in the ESRD population.

RESULTS

A total of 137 ESRD patients were enrolled. The prevalence of RLS among the ESRD patients was 20.44%. The risk of RLS was increased significantly in females (OR = 2.729, p = 0.032) and daily alcohol drinkers (OR = 4.716, p = 0.022). RLS increased the risks of sleep disorders (25/28, 89.3% vs 73/109, 67.0%, p = 0.02) and sedative hypnotics intake (7/28, 25.0% vs 10/109, 9.2%, p = 0.047) and impaired the sleep quality (7/109 vs 11/28, p = 0.001) according to PSQI sum scores.

CONCLUSION

A high RLS prevalence among the ESRD patients undergoing hemodialysis was confirmed. ESRD patients who are women and drinking alcohol have a higher risk of RLS. The sleep quality was significantly impaired and sleeping medication use was more common among the ESRD patients with RLS.

摘要

背景

终末期肾病(ESRD)患者中不安腿综合征(RLS)的患病率高于普通人群。然而,ESRD人群中RLS的相关因素并不一致,并且RLS在透析中心通常被忽视,尽管它会损害ESRD患者的生活质量。我们旨在调查接受维持性血液透析的ESRD患者中RLS的患病率,评估发生RLS的危险因素以及RLS对ESRD患者生活质量的影响。

方法

纳入2016年7月至2016年10月在上海交通大学医学院附属瑞金医院透析中心接受维持性血液透析的ESRD患者。根据国际不安腿综合征研究组(IRLSSG)的标准诊断RLS。使用IRLSSG严重程度量表评估RLS的严重程度。匹兹堡睡眠质量指数(PSQI)用于评估睡眠质量,医院焦虑抑郁量表(HADS)用于评估焦虑和抑郁。分析血清学和病史变量以确定ESRD人群中RLS的预测因素。

结果

共纳入137例ESRD患者。ESRD患者中RLS的患病率为20.44%。女性(OR = 2.729,p = 0.032)和每日饮酒者(OR = 4.716,p = 0.022)发生RLS的风险显著增加。根据PSQI总分,RLS增加了睡眠障碍(25/28,89.3%对73/109,67.0%,p = 0.02)和使用镇静催眠药(7/28,25.0%对10/109,9.2%,p = 0.047)的风险,并损害了睡眠质量(7/109对11/28,p = 0.001)。

结论

证实接受血液透析的ESRD患者中RLS患病率较高。女性和饮酒的ESRD患者发生RLS的风险较高。RLS患者的睡眠质量明显受损,使用助眠药物更为常见。

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