Restless legs syndrome enhances cardiovascular risk and mortality in patients with end-stage kidney disease undergoing long-term haemodialysis treatment

Gaetano La Manna, Fabio Pizza, Elisa Persici, Olga Baraldi, Giorgia Comai, Maria Laura Cappuccilli, Francesca Centofanti, Elisa Carretta, Giuseppe Plazzi, Luigi Col, Pasquale Montagna, Sergio Stefoni

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Abstract

Background. Restless legs syndrome (RLS) is a sensorimotor neurological disorder characterized by paraesthesia, dysaesthesia and the irresistible urge to move the legs especially at night. Its prevalence is much higher among dialysis patients at 12 to 62% compared to 3 to 9% in the general population. Here, we investigated the association between RLS and cardiovascular events risk and laboratory parameters in end-stage kidney disease (ESKD) patients on dialysis.Methods. One hundred ESKD patients undergoing haemodialysis were enrolled in an 18-month prospective observational study. The main outcomes were the associations of RLS with new cardiovascular events and cardiovascular mortality.Results. RLS affected 31% of the study population. It was associated with female gender, gradual reduction in residual diuresis, lower albumin (P = 0.039) and inflammation, but not the dialysis parameters Kt/V and URR. During observation, 47% of patients experienced new cardiovascular events (64.5% with and 39.1% without RLS; P = 0.019). New cardiovascular events increased with severity of RLS [intermittent (I-RLS) vs continuous (C-RLS)]. Mortality was 20.0% in all patients, 32.3% in those with and 14.5% in patients without RLS (P = 0.04). In patients with I-RLS, mortality was 23.8% compared to 55.6% in patients with C-RLS (P = 0.014). Multivariate analysis confirmed the relationship between RLS and mortality.Conclusions. This study confirmed the high prevalence of RLS among dialysis patients and the associations between the severity of RLS and the risk of new cardiovascular events and higher short-term mortality.

Original languageEnglish
Pages (from-to)1976-1983
Number of pages8
JournalNephrology Dialysis Transplantation
Volume26
Issue number6
DOIs
Publication statusPublished - Jun 2011

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Restless Legs Syndrome
Chronic Kidney Failure
Renal Dialysis
Mortality
Therapeutics
Dialysis
Paresthesia
Diuresis
Nervous System Diseases
Population

Keywords

  • cardiovascular outcome
  • haemodialysis
  • mortality
  • restless legs syndrome

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Restless legs syndrome enhances cardiovascular risk and mortality in patients with end-stage kidney disease undergoing long-term haemodialysis treatment. / La Manna, Gaetano; Pizza, Fabio; Persici, Elisa; Baraldi, Olga; Comai, Giorgia; Cappuccilli, Maria Laura; Centofanti, Francesca; Carretta, Elisa; Plazzi, Giuseppe; Col, Luigi; Montagna, Pasquale; Stefoni, Sergio.

In: Nephrology Dialysis Transplantation, Vol. 26, No. 6, 06.2011, p. 1976-1983.

Research output: Contribution to journalArticle

La Manna, G, Pizza, F, Persici, E, Baraldi, O, Comai, G, Cappuccilli, ML, Centofanti, F, Carretta, E, Plazzi, G, Col, L, Montagna, P & Stefoni, S 2011, 'Restless legs syndrome enhances cardiovascular risk and mortality in patients with end-stage kidney disease undergoing long-term haemodialysis treatment', Nephrology Dialysis Transplantation, vol. 26, no. 6, pp. 1976-1983. https://doi.org/10.1093/ndt/gfq681
La Manna, Gaetano ; Pizza, Fabio ; Persici, Elisa ; Baraldi, Olga ; Comai, Giorgia ; Cappuccilli, Maria Laura ; Centofanti, Francesca ; Carretta, Elisa ; Plazzi, Giuseppe ; Col, Luigi ; Montagna, Pasquale ; Stefoni, Sergio. / Restless legs syndrome enhances cardiovascular risk and mortality in patients with end-stage kidney disease undergoing long-term haemodialysis treatment. In: Nephrology Dialysis Transplantation. 2011 ; Vol. 26, No. 6. pp. 1976-1983.
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abstract = "Background. Restless legs syndrome (RLS) is a sensorimotor neurological disorder characterized by paraesthesia, dysaesthesia and the irresistible urge to move the legs especially at night. Its prevalence is much higher among dialysis patients at 12 to 62{\%} compared to 3 to 9{\%} in the general population. Here, we investigated the association between RLS and cardiovascular events risk and laboratory parameters in end-stage kidney disease (ESKD) patients on dialysis.Methods. One hundred ESKD patients undergoing haemodialysis were enrolled in an 18-month prospective observational study. The main outcomes were the associations of RLS with new cardiovascular events and cardiovascular mortality.Results. RLS affected 31{\%} of the study population. It was associated with female gender, gradual reduction in residual diuresis, lower albumin (P = 0.039) and inflammation, but not the dialysis parameters Kt/V and URR. During observation, 47{\%} of patients experienced new cardiovascular events (64.5{\%} with and 39.1{\%} without RLS; P = 0.019). New cardiovascular events increased with severity of RLS [intermittent (I-RLS) vs continuous (C-RLS)]. Mortality was 20.0{\%} in all patients, 32.3{\%} in those with and 14.5{\%} in patients without RLS (P = 0.04). In patients with I-RLS, mortality was 23.8{\%} compared to 55.6{\%} in patients with C-RLS (P = 0.014). Multivariate analysis confirmed the relationship between RLS and mortality.Conclusions. This study confirmed the high prevalence of RLS among dialysis patients and the associations between the severity of RLS and the risk of new cardiovascular events and higher short-term mortality.",
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AU - La Manna, Gaetano

AU - Pizza, Fabio

AU - Persici, Elisa

AU - Baraldi, Olga

AU - Comai, Giorgia

AU - Cappuccilli, Maria Laura

AU - Centofanti, Francesca

AU - Carretta, Elisa

AU - Plazzi, Giuseppe

AU - Col, Luigi

AU - Montagna, Pasquale

AU - Stefoni, Sergio

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N2 - Background. Restless legs syndrome (RLS) is a sensorimotor neurological disorder characterized by paraesthesia, dysaesthesia and the irresistible urge to move the legs especially at night. Its prevalence is much higher among dialysis patients at 12 to 62% compared to 3 to 9% in the general population. Here, we investigated the association between RLS and cardiovascular events risk and laboratory parameters in end-stage kidney disease (ESKD) patients on dialysis.Methods. One hundred ESKD patients undergoing haemodialysis were enrolled in an 18-month prospective observational study. The main outcomes were the associations of RLS with new cardiovascular events and cardiovascular mortality.Results. RLS affected 31% of the study population. It was associated with female gender, gradual reduction in residual diuresis, lower albumin (P = 0.039) and inflammation, but not the dialysis parameters Kt/V and URR. During observation, 47% of patients experienced new cardiovascular events (64.5% with and 39.1% without RLS; P = 0.019). New cardiovascular events increased with severity of RLS [intermittent (I-RLS) vs continuous (C-RLS)]. Mortality was 20.0% in all patients, 32.3% in those with and 14.5% in patients without RLS (P = 0.04). In patients with I-RLS, mortality was 23.8% compared to 55.6% in patients with C-RLS (P = 0.014). Multivariate analysis confirmed the relationship between RLS and mortality.Conclusions. This study confirmed the high prevalence of RLS among dialysis patients and the associations between the severity of RLS and the risk of new cardiovascular events and higher short-term mortality.

AB - Background. Restless legs syndrome (RLS) is a sensorimotor neurological disorder characterized by paraesthesia, dysaesthesia and the irresistible urge to move the legs especially at night. Its prevalence is much higher among dialysis patients at 12 to 62% compared to 3 to 9% in the general population. Here, we investigated the association between RLS and cardiovascular events risk and laboratory parameters in end-stage kidney disease (ESKD) patients on dialysis.Methods. One hundred ESKD patients undergoing haemodialysis were enrolled in an 18-month prospective observational study. The main outcomes were the associations of RLS with new cardiovascular events and cardiovascular mortality.Results. RLS affected 31% of the study population. It was associated with female gender, gradual reduction in residual diuresis, lower albumin (P = 0.039) and inflammation, but not the dialysis parameters Kt/V and URR. During observation, 47% of patients experienced new cardiovascular events (64.5% with and 39.1% without RLS; P = 0.019). New cardiovascular events increased with severity of RLS [intermittent (I-RLS) vs continuous (C-RLS)]. Mortality was 20.0% in all patients, 32.3% in those with and 14.5% in patients without RLS (P = 0.04). In patients with I-RLS, mortality was 23.8% compared to 55.6% in patients with C-RLS (P = 0.014). Multivariate analysis confirmed the relationship between RLS and mortality.Conclusions. This study confirmed the high prevalence of RLS among dialysis patients and the associations between the severity of RLS and the risk of new cardiovascular events and higher short-term mortality.

KW - cardiovascular outcome

KW - haemodialysis

KW - mortality

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