Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt.
Department of Internal Medicine, Assiut University Hospital, Assiut, Egypt.
Int J Neurosci. 2023 Mar;133(3):257-268. doi: 10.1080/00207454.2021.1910256. Epub 2021 Oct 11.
Chronic kidney disease (CKD) is a common cause of restless leg syndrome (RLS). RLS is under-recognized, misdiagnosed and undertreated disorder in our locality. In this study, we aimed to determine the prevalence of RLS due to CKD and its predictors.
This cross-sectional study included 520 patients [male = 200; female = 320; age: 48.45 ± 3.63yrs; uremia duration: 6.44 ± 1.65yrs; CKD5D = 400; CKD3D = 120). RLS diagnosis was done by clinical interviewing according to International RLS Study Group criteria. All underwent detailed biochemical testing and iron and ferritin levels' measurements. Insomnia, depression and anxiety severities were assessed using insomnia sleep index (ISI), Beck Depression Inventory (BDI-II) and State-Trait Anxiety Inventory for Adults (STAI-AD) scales.
RLS was found in 22.31% [ESKD = 26%, CKD3D = 10%]. Insomnia, depression and anxiety were found in 76.15%, 91.15% and 44.23%, respectively. Insomnia was correlated with depression ( = 0.488, = 0.001) and anxiety ( = 0.360, = 0.006) but not RLS. Multiple linear regression analysis showed that ESKD (OR = 3.8, 95%CI = 2.5-8.5, = 0.001), inadequate dialysis (OR = 4.6, 95%CI = 3.5-8.6, = 0.001), hyperparathyroidism (OR = 5.1, 95%CI 3.2-13.7, = 0.0001) and peripheral neuropathy (OR = 5.6, 95%CI = 3.8-12.8, = 0.0001) were independently associated with RLS.
The prevalence of RLS with CKD is 22.31%. It is 2.6 times more frequent and severe with ESKD compared to CKD3D. It seems that RLS may occur early with CKD and becomes worse with progressive kidney impairment. Also, insomnia, depression and anxiety are common with CKD, however, their severities were not correlated with RLS. Predictors for RLS were ESKD, inadequacy of dialysis, hyperparathyroidism and peripheral neuropathy.
慢性肾脏病（CKD）是不安腿综合征（RLS）的常见病因。RLS 在我们的地区未得到充分认识、误诊和治疗不足。在这项研究中，我们旨在确定由 CKD 引起的 RLS 的患病率及其预测因素。
这项横断面研究纳入了 520 名患者[男性=200；女性=320；年龄：48.45±3.63 岁；尿毒症持续时间：6.44±1.65 年；CKD5D=400；CKD3D=120]。RLS 的诊断是根据国际 RLS 研究组的标准通过临床访谈进行的。所有患者均接受详细的生化检测和铁及铁蛋白水平的测量。使用失眠睡眠指数（ISI）、贝克抑郁量表（BDI-II）和成人状态特质焦虑量表（STAI-AD）评估失眠、抑郁和焦虑的严重程度。
RLS 的检出率为 22.31%[终末期肾病（ESKD）=26%，CKD3D=10%]。失眠、抑郁和焦虑的检出率分别为 76.15%、91.15%和 44.23%。失眠与抑郁（ = 0.488， = 0.001）和焦虑（ = 0.360， = 0.006）相关，但与 RLS 无关。多线性回归分析显示，ESKD（OR=3.8，95%CI=2.5-8.5， = 0.001）、透析不充分（OR=4.6，95%CI=3.5-8.6， = 0.001）、甲状旁腺功能亢进（OR=5.1，95%CI=3.2-13.7， = 0.0001）和周围神经病变（OR=5.6，95%CI=3.8-12.8， = 0.0001）与 RLS 独立相关。
CKD 合并 RLS 的患病率为 22.31%。与 CKD3D 相比，ESKD 时 RLS 的发生率增加了 2.6 倍，且更严重。似乎 RLS 在 CKD 早期就可能发生，并随着肾脏损伤的进展而恶化。此外，失眠、抑郁和焦虑在 CKD 中很常见，但它们的严重程度与 RLS 无关。RLS 的预测因素为 ESKD、透析不充分、甲状旁腺功能亢进和周围神经病变。
