American Journal of Kidney Diseases
Volume 43, Issue 5 , Pages 900-909 , May 2004

Restless legs symptoms among incident dialysis patients: Association with lower quality of life and shorter survival

  • Mark L Unruh, MD

      Affiliations

    • Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
    • Corresponding Author InformationAddress reprint requests to Mark Unruh, MD, University of Pittsburgh Medical Center, Renal-Electrolyte Division, 3550 Terrace St, A909 Scaife Hall, Pittsburgh, PA 15261, USA
    • ,
  • Andrew S Levey, MD

      Affiliations

    • Division of Nephrology, Tufts-New England Medical Center, Boston, MA, USA
    • ,
  • Carolyn D’Ambrosio, MD

      Affiliations

    • Division of Pulmonology, Tufts-New England Medical Center, Boston, MA, USA
    • ,
  • Nancy E Fink, MPH

      Affiliations

    • Johns Hopkins University, Baltimore, MD, USA
    • ,
  • Neil R Powe, MD

      Affiliations

    • Johns Hopkins University, Baltimore, MD, USA
    • ,
  • Klemens B Meyer, MD

      Affiliations

    • Division of Nephrology, Tufts-New England Medical Center, Boston, MA, USA
    • ,
  • Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study

Received 11 August 2003 ,Revised 26 January 2004 ,Accepted 26 January 2004.

References 

  1. Winkelman JW, Chertow GM, Lazarus JM. Restless legs syndrome in end-stage renal disease. Am J Kidney Dis. 1996;28:372–378
  2. Holley JL, Nespor S, Rault R. Characterizing sleep disorders in chronic hemodialysis patients. ASAIO Trans. 1991;37:M456–M457
  3. Walker S, Fine A, Kryger MH. Sleep complaints are common in a dialysis unit. Am J Kidney Dis. 1995;26:751–756
  4. Chesson AL, Wise M, Davila D, et al.  Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep. 1999;22:961–968
  5. Walters AS. Toward a better definition of the restless legs syndrome. The International Restless Legs Syndrome Study Group. Mov Disord. 1995;10:634–642
  6. Phillips B, Young T, Finn L, Asher K, Hening WA, Purvis C. Epidemiology of restless legs symptoms in adults. Arch Intern Med. 2000;160:2137–2141
  7. Collado-Seidel V, Kohnen R, Samtleben W, Hillebrand GF, Oertel WH, Trenkwalder C. Clinical and biochemical findings in uremic patients with and without restless legs syndrome. Am J Kidney Dis. 1998;31:324–328
  8. Takaki J, Nishi T, Nangaku M, et al.  Clinical and psychological aspects of restless legs syndrome in uremic patients on hemodialysis. Am J Kidney Dis. 2003;41:833–839
  9. Cirignotta F, Mondini S, Santoro A, Ferrari G, Gerardi R, Buzzi G. Reliability of a questionnaire screening restless legs syndrome in patients on chronic dialysis. Am J Kidney Dis. 2002;40:302–306
  10. Ruottinen HM, Partinen M, Hublin C, et al.  An FDOPA PET study in patients with periodic limb movement disorder and restless legs syndrome. Neurology. 2000;54:502–504
  11. Parker K. Sleep disturbances in dialysis patients. Sleep Med Rev. 2003;7:131–143
  12. Powe N, Klag M, Sadler J. Choices for Health Outcomes in Caring for End-Stage Renal Disease. Semin Dial. 1996;9:9–11
  13. Edgell ET, Coons SJ, Carter WB, et al.  A review of health-related quality-of-life measures used in end-stage renal disease. Clin Ther. 1996;18:887–938
  14. Athienites NV, Miskulin DC, Fernandez G, et al.  Comorbidity assessment in hemodialysis and peritoneal dialysis using the Index of Coexistent Disease. Semin Dial. 2000;13:320–326
  15. Miskulin DC, Athienites NV, Yan G, et al.  Comorbidity assessment using the Index of Coexistent Diseases in a multicenter clinical trial. Kidney Int. 2001;60:1498–1510
  16. Miskulin DC, Meyer KB, Athienites NV, et al.  Comorbidity and other factors associated with modality selection in incident dialysis patients: The CHOICE Study. Choices for Healthy Outcomes in Caring for End-Stage Renal Disease. Am J Kidney Dis. 2002;39:324–336
  17. Wu AW, Fink NE, Cagney KA, et al.  Developing a health-related quality-of-life measure for end-stage renal disease (The CHOICE Health Experience Questionnaire). Am J Kidney Dis. 2001;37:11–21
  18. Ware J, Snow K, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston, MA: The Health Institute, New England Medical Center; 1993;
  19. Localio AR, Berlin JA, Ten Have TR, Kimmel SE. Adjustments for center in multicenter studies (An overview). Ann Intern Med. 2001;135:112–123
  20. US Renal Data System . The USRDS Dialysis Morbidity and Mortality Study (Wave 2). Am J Kidney Dis. 1997;30(suppl 1):S67–S85
  21. US Renal Data System . The USRDS Dialysis Morbidity and Mortality Study (Wave I). Am J Kidney Dis. 1996;28(suppl 2):S58–S78
  22. Ulfberg J, Nystrom B, Carter N, Edling C. Restless legs syndrome among working-aged women. Eur Neurol. 2001;46:17–19
  23. Ulfberg J, Nystrom B, Carter N, Edling C. Prevalence of restless legs syndrome among men aged 18 to 64 years (An association with somatic disease and neuropsychiatric symptoms). Mov Disord. 2001;16:1159–1163
  24. Tanaka K, Morimoto N, Tashiro N, Hori K, Katafuchi R, Fujimi S. The features of psychological problems and their significance in patients on hemodialysis—With reference to social and somatic factors. Clin Nephrol. 1999;51:161–176
  25. Rothdach AJ, Trenkwalder C, Haberstock J, Keil U, Berger K. Prevalence and risk factors of RLS in an elderly population: The MEMO study. Memory and Morbidity in Augsburg Elderly. Neurology. 2000;54:1064–1068
  26. Trenkwalder C, Stiasny K, Pollmacher T, et al.  L-Dopa therapy of uremic and idiopathic restless legs syndrome (A double-blind, crossover trial). Sleep. 1995;18:681–688
  27. Kimmel PL, Emont SL, Newmann JM, Danko H, Moss AH. ESRD patient quality of life (Symptoms, spiritual beliefs, psychosocial factors, and ethnicity). Am J Kidney Dis. 2003;42:713–721
  28. Ferrara M, De Gennaro L, Bertini M. The effects of slow-wave sleep (SWS) deprivation and time of night on behavioral performance upon awakening. Physiol Behav. 1999;68:55–61
  29. Drummond SP, Brown GG, Gillin JC, Stricker JL, Wong EC, Buxton RB. Altered brain response to verbal learning following sleep deprivation. Nature. 2000;403:655–657
  30. Ferrara M, De Gennaro L, Casagrande M, Bertini M. Selective slow-wave sleep deprivation and time-of-night effects on cognitive performance upon awakening. Psychophysiology. 2000;37:440–446
  31. Benz RL, Pressman MR, Hovick ET, Peterson DD. Potential novel predictors of mortality in end-stage renal disease patients with sleep disorders. Am J Kidney Dis. 2000;35:1052–1060
  32. Lofaso F, Coste A, Gilain L, Harf A, Guilleminault C, Goldenberg F. Sleep fragmentation as a risk factor for hypertension in middle-aged nonapneic snorers. Chest. 1996;109:896–900
  33. Lofaso F, Goldenberg F, d’Ortho MP, Coste A, Harf A. Arterial blood pressure response to transient arousals from NREM sleep in nonapneic snorers with sleep fragmentation. Chest. 1998;113:985–991
  34. Sabbatini M, Minale B, Crispo A, et al.  Insomnia in maintenance haemodialysis patients. Nephrol Dial Transplant. 2002;17:852–856
  35. Winkelmann J, Stautner A, Samtleben W, Trenkwalder C. Long-term course of restless legs syndrome in dialysis patients after kidney transplantation. Mov Disord. 2002;17:1072–1076
  36. Walters AS, Hickey K, Maltzman J, et al.  A questionnaire study of 138 patients with restless legs syndrome (The “Night-Walkers” survey). Neurology. 1996;46:92–95
  37. Kutner N, Bliwise D. Restless legs complaint in African-American and Caucasian hemodialysis patients. Sleep Med. 2002;3:497–500
  38. O’Keeffe ST. Restless legs syndrome. A review. Arch Intern Med. 1996;156:243–248
  39. Dimmitt SB, Riley GJ. Selective serotonin receptor uptake inhibitors can reduce restless legs symptoms. Arch Intern Med. 2000;160:712
  40. Wetter TC. Restless legs syndrome (A review for the renal care professionals). EDTNA ERCA J. 2001;26:42–46
  41. Janzen L, Rich JA, Vercaigne LM. An overview of levodopa in the management of restless legs syndrome in a dialysis population (Pharmacokinetics, clinical trials, and complications of therapy). Ann Pharmacother. 1999;33:86–92
  42. Hening W, Allen R, Earley C, Kushida C, Picchietti D, Silber M. The treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Review. Sleep. 1999;22:970–999
  43. Sun ER, Chen CA, Ho G, Earley CJ, Allen RP. Iron and the restless legs syndrome. Sleep. 1998;21:371–377
  44. Earley CJ, Connor JR, Beard JL, Malecki EA, Epstein DK, Allen RP. Abnormalities in CSF concentrations of ferritin and transferrin in restless legs syndrome. Neurology. 2000;54:1698–1700
  45. Earley CJ, Allen RP, Beard JL, Connor JR. Insight into the pathophysiology of restless legs syndrome. J Neurosci Res. 2000;62:623–628
  46. Allen RP, Barker PB, Wehrl F, Song HK, Earley CJ. MRI measurement of brain iron in patients with restless legs syndrome. Neurology. 2001;56:263–265
  47. Thorp ML, Morris CD, Bagby SP. A crossover study of gabapentin in treatment of restless legs syndrome among hemodialysis patients. Am J Kidney Dis. 2001;38:104–108

☆ Supported in part by grant no. R01-HS-08365 from the Agency for Healthcare Research and Quality from June 1995 to May 2000 (CHOICE Study); grants no. R01-HL-62985, R01-DK-07024 (CHOICE Study), and K24-DK-02643 (N.R.P.) from the National Institute of Diabetes and Digestive and Kidney Diseases; and an American Society of Nephrology-Association for Subspecialty Professors Junior Development Grant in Geriatric Nephrology (M.L.U.).

PII: S0272-6386(04)00143-X

doi: 10.1053/j.ajkd.2004.01.013

American Journal of Kidney Diseases
Volume 43, Issue 5 , Pages 900-909 , May 2004

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