Abstract
Restless legs syndrome (RLS) is a sensorimotor neurological disorder characterized by paresthesia, dysesthesia and the irresistible urge to move the legs, especially at night. Its prevalence is much higher among dialysis patients than in the general public. RLS is known to be associated with depression and quality of life. Recently, the association between the severity of RLS and the risk of new cardiovascular events in hemodialysis patients was also reported. In this study, we examined the relationship between RLS and mortality in hemodialysis patients. A total of 67 patients receiving maintenance hemodialysis at Sangenjaya Hospital were enrolled in this study. Clinical data, including age, gender, duration of hemodialysis therapy, complication of cardiovascular disease and cause of end-stage kidney disease, were collected. The clinical follow-up data were obtained from the hospital records. The clinical endpoints were defined as death from any cause and cardiovascular death. Cox proportional hazards model for predictors of survival was examined. RLS affected 14.9% of the study population. The mean observation period was 3.2±1.0 years. During the follow-up period, 20 deaths were recorded. In univariate regression analysis, the hazard ratio (HR) of patients with RLS was 1.79 (95% CI 1.07-2.84, p=0.030) for all-cause death and 2.97 (95% CI 1.52-5.99, p=0.002) for cardiovascular death. Multivariate Cox analysis, which included creatinine, presence of diabetic nephropathy and presence of cardiovascular disease, identified RLS as an independent predictor of mortality (HR 1.72, 95% CI 1.02-2.73, p=0.044). RLS was a risk factor for mortality, especially for cardiovascular death, and acted independently of other risk factors, including creatinine, presence of diabetic nephropathy and presence of cardiovascular disease in Japanese single-unit hemodialysis patients.
