Clinical and psychological aspects of restless legs syndrome in uremic patients on hemodialysis

Takaki, Jiro; Nishi, Tadahiro; Nangaku, Masaomi; Shimoyama, Hiromi; Inada, Toshio; Matsuyama, Norimasa; Kumano, Hiroaki; Kuboki, Tomifusa

« Previous Next »American Journal of Kidney Diseases
Volume 41, Issue 4 , Pages 833-839, April 2003

Clinical and psychological aspects of restless legs syndrome in uremic patients on hemodialysis

Jiro Takaki, MD
- Address reprint requests to Jiro Takaki, MD, Department of Psychosomatic Medicine, Tokyo University Hospital, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
- Department of Psychosomatic Medicine, Faculty of Medicine, University of Tokyo, TokyoJapan
Tadahiro Nishi, MD
- Nishi Clinic, TokyoJapan
Masaomi Nangaku, MD
- Division of Nephrology and Endocrinology, Faculty of Medicine, the University of Tokyo, TokyoJapan
Hiromi Shimoyama, MD
- Yuuai Clinic, Saitama, Japan
Toshio Inada, MD
- Bousei Tanashi Clinic, TokyoJapan
Norimasa Matsuyama, MD
- Tokyo Kensei Hospital, TokyoJapan
Hiroaki Kumano, MD
- Department of Psychosomatic Medicine, Faculty of Medicine, University of Tokyo, TokyoJapan
Tomifusa Kuboki, MD
- Department of Psychosomatic Medicine, Faculty of Medicine, University of Tokyo, TokyoJapan

Received 27 June 2002; received in revised form 26 November 2002; accepted 26 November 2002.

Abstract

: The pathogenesis of restless legs syndrome (RLS) is still unclear. The purpose of this study is to determine relationships of the presence of RLS in uremic patients regularly undergoing hemodialysis (HD) with demographic, clinical, and psychological factors.

: In 490 uremic patients on HD therapy in Japan, RLS was diagnosed based on diagnostic criteria established by the International Restless Legs Syndrome Study Group. Data were compared between patients with and without RLS.

: There were univariately significant (P < 0.05) differences in serum phosphorus levels, anxiety levels determined using the Hospital Anxiety and Depression Scale, and degrees of emotion-oriented and avoidance-oriented coping determined using the Coping Inventory for Stressful Situations. In multivariate analyses, low hemoglobin levels, high serum phosphorus levels, high anxiety levels, and a great degree of emotion-oriented coping were independently related to the presence of RLS in uremic patients on HD therapy, with statistical significance (P < 0.05).

: Hyperphosphatemia, anxiety, and a great degree of emotion-oriented coping with stress were independently related to the presence of RLS in uremic patients on HD therapy. The pathogenesis of RLS seems to involve more than one mechanism, which leads to restless legs as the final common pathway. These findings may provide new clues to the pathogenesis of RLS.

Keywords: Restless legs syndrome (RLS), hemodialysis (HD), hemoglobin, phosphorus, anxiety, coping