Sindrom nemirnih nogu kod pacijenata na hemodijalizi: učestalost, težina i faktori rizika

Nikola Sladojević

doi:10.5937/mckg46-2330

Nikola Sladojević Departments of Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA

DOI: https://doi.org/10.5937/mckg46-2330

Sažetak

Sindrom nemirnih nogu je neurološki poremećaj koji posebno pogađa pacijente na hemodijalizi. Cilj studije je da prikaže učestalost i težinu sindroma nemirnih nogu u populaciji hemodijaliznih pacijenata i razmotri moguću povezanost sa određenih faktorima analizirajući razlike između pacijenata sa dijagnozom sindroma i bez dijagnoze u sociodemografskim karakteristikama, prisustvu i težini komorbidnih stanja, biohemijskim parametrima i vrsti hemodijalizne tehnike. Studijom preseka obuhvaćeno je 96 pacijenata. Dijagnoza sindroma nemirnih nogu postavljena je na osnovu dijagnostičkih kriterijuma Međunarodne studijske grupe za sindrom nemirnih nogu. Za procenu težine korišćen je upitnik Restless Legs Syndrome Rating Scale. Sindrom nemirnih nogu bio je prisutan kod 39.6% ispitanika. Većina pacijenata imala je umerene (36.8%) ili jako izražene simptome (50%). Nije bilo statistički značajne razlike u sociodemografskim i biohemijskim karakteristikama i vrsti dijalize između pacijenata sa sindromom nemirnih nogu i bez sindroma. Što se tiče udruženih bolesti nađeno je da pacijenti sa sindromom nemirnih nogu imaju statistički značajno veću učestalost ishemijske bolesti srca i depresivnosti, dok u ukupnom indeksu težine pratećih oboljenja nema razlike. Težina depresivnosti i nesanice su izraženiji kod pacijenata sa sindromom nemirnih nogu. Naša studija je potvrdila visoku učestalost sindroma kod pacijenata na hemodijalizi i pokazala da čak dve trećine pacijenata ima jake do veoma jake simptome. Posebnu pažnju potrebno je usmeriti na uticaj komorbiditeta na sindrom nemirnih nogu u ovoj grupi pacijenata, posebno onih iz grupe psihijatrijskih bolesti.

Reference

National Heart, Lung, and Blood Institute Working Group on Restless Legs Syndrome. Restless legs syndrome. Detection and management in primary care. Am Fam Phys 2000; 62: 108-14.

Allen, RP, Picchietti, D, Hening, WA, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology; a report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003; 4, 101-119.

Mark Buchfuhrer. Restless legs syndrome. 2012. (http://www.rlshelp.org/rlshomepage.htm).

Berger K, Luedemann J, Trenkwalder C, et al. Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 2004; 164: 196-202.

Högl B, Kiechl S, Willeit J, at al. Restless legs syndrome: a community-based study of prevalence, severity, and risk factors. Neurology 2005; 64: 1920-4.

Kovacs AZ, Molnar MZ, Szeifert L, et al. Sleep disorders, depressive symptoms and health-related quality of life – a cross-sectional comparasion between kidney transplant recipients and waitlisted patients on maintenance dialysis. Nephrol Dial Transplant 2011; 26: 1058-1065.

Merlino G, Piani A, Dolso P, et al. Sleep disorders in patients with end-stage renal disease undergoing dialysis therapy. Nephrol Dial Transplant 2006; 21: 184-190.

Salman SM. Restless legs syndrome in patients on hemodialysis. Saudi J Kidney Dis Transpl 2011; 22: 368-72.

Nikić PM, Andrić BR, Stojanović-Stanojević M, Đorđević V, Petrović D, Stojimirović BB. Prevalencija sindroma nemirnih nogu kod bolesnika na hroničnoj hemodijalizi u centralnoj Srbiji. Vojnosanitetski pregled 2007; 64: 129-134.

Kim JM, Kwon HM, Lim CS, Kim YS, Lee SJ, Nam H. Restless legs syndrome in patients on hemodialysis: symptom severity and risk factors. J Clin Neurol 2008; 4: 153-7.

Sabry AA, Abo-Zenah H, Wafa E, et al. Sleep disorders in hemodialysis patients. Saudi J Kidney Dis Transpl 2010; 21: 300-305.

Bastos JP, Sousa RB, Nepomuceno LA, et al. Sleep disturbances in patients on maintenance hemodialysis: role of dialysis shift. Rev Assoc Med Bras 2007; 53: 492-6.

Merlino G, Lorenzut S, Romano G, et al. Restless legs syndrome in dialysis patients: a comparison between hemodialysis and continuous ambulatory peritoneal dialysis. Neurol Sci 2012 [Epub of head].

Kavanagh D, Siddiqui S, Geddes CC. Restless legs syndrome in patients on dialysis. Am J Kidney Dis 2004; 43: 763-71.

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: 833-9.

Abetz L, Allen R, Follet A, et al. Evaluating the quality of life of patients with restless legs syndrome. Clin Ther 2004; 26: 925-35.

Silber MH. Restless legs syndrome. Mayo Clin Proc 1997; 72: 261-4.

Evidente VG, Adler CH. How to help patients with restless legs syndrome. Discerning the indescribable and relaxing the restless. Postgrad Med 1999; 105: 59-61, 65-6, 73-4.

Walters AS, LeBrocq C, Dhar A, et al; The International Restless Legs Syndrome Study Group. Validation of the International Restless Legs Syndrome Study Group Rating Scale for restless legs syndrome. Sleep Med 2003; 4: 121-132.

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: 320-6.

Beck AT, Ward C, Mendelson M. Beck Depression Inventory (BDI). Arch Gen Psychiatry 1961; 4: 561–71.

Bastien CH, Vallières A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2001; 2: 297-307.

Siddiqui S, Kavanagh D, Traynor J, Mak M, Deighan C, Geddes C. Risk factors for restless legs syndrome in dialysis patients. Nephron Clin Pract 2005; 101: c155-60.

Cho YW, Lee H, Lee JH, Han SY, Lee MY. Sleep disorders in maintenance dialysis patients with end stage renal disease. J Korean Neurol Assoc 2003; 21: 492-497.

Mucsi I, Molnar MZ, Ambrus C, et al. Restless legs syndrome, insomnia and quality of life in patients on maintenance dialysis. Nephrol Dial Transplant 2005; 20: 571-7.

Tuncel D, Orhan FO, Sayarlioglu H, Isık IO, Utku U, Dinc A. Restless legs syndrome in hemodialysis patients: association with depression and quality of life. Sleep Breath 2011; 15: 311-5.

Ulfberg J, Nyström 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: 1159-63.

Jhoo JH, Yoon IY, Kim YK, et al. Availability of brain serotonin transporters in patients with restless legs syndrome. Neurology 2010; 74: 513-8.

Canaud B, Krieter D. Hemodiafiltration and hemofiltration. In: Daugirdas JT, Blake PG, Ing TS, eds. Handbook of dialysis. 4th edition. Philadelphia: Lippincott Williams and Wilkins, Wolters Kluwer; 2007: 265-275.

Leypoldt JK. Solute fluxes in different treatment modalities. Nephrol Dial Transplant 2000; 15 Suppl 1: 3-9.

Ward RA, Schmidt B, Hullin J, Hillebrand GF, Samtleben W. A comparison of on-line hemodiafiltration and high-flux hemodialysis: a prospective clinical study. J Am Soc Nephrol 2000; 11: 2344-2350.

Allen RP, Barker PB, Wehrl F, et al. MRI measurement of brain iron in patients with restless legs syndrome. Neurology 2001; 56: 263-265.

Connor JR, Wang XS, Patton SM, et al. Decreased transferrin receptor expression by neuromelanin cells in restless legs syndrome. Neurology 2004; 62: 1563-1567.

Mizuno S, Mihara T, Miyaoka T, et al. CSF iron, ferritin and transferrin levels in restless legs syndrome. J Sleep Res 2005; 14: 43-47.