Clinical characteristics of restless legs syndrome in end-stage renal failure and idiopathic RLS patients
Minori Enomoto RMT, RPSGT
Japan Somnology center, Neuropsychiatric Research Institute, Tokyo, Japan
Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
Department of Life Sciences and Bio-informatics, Graduate School of Allied Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Search for more papers by this authorCorresponding Author
Yuichi Inoue MD, PhD
Japan Somnology center, Neuropsychiatric Research Institute, Tokyo, Japan
Japan Somnology Center, Neuropsychiatric Research Institute, 1-17-7 Yoyogi Shibuya-ku, Tokyo 151-0053, JapanSearch for more papers by this authorKazuyoshi Namba
Japan Somnology center, Neuropsychiatric Research Institute, Tokyo, Japan
Search for more papers by this authorTakashi Munezawa
Japan Somnology center, Neuropsychiatric Research Institute, Tokyo, Japan
Search for more papers by this authorMasato Matsuura MD, PhD
Department of Life Sciences and Bio-informatics, Graduate School of Allied Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Search for more papers by this authorMinori Enomoto RMT, RPSGT
Japan Somnology center, Neuropsychiatric Research Institute, Tokyo, Japan
Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
Department of Life Sciences and Bio-informatics, Graduate School of Allied Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Search for more papers by this authorCorresponding Author
Yuichi Inoue MD, PhD
Japan Somnology center, Neuropsychiatric Research Institute, Tokyo, Japan
Japan Somnology Center, Neuropsychiatric Research Institute, 1-17-7 Yoyogi Shibuya-ku, Tokyo 151-0053, JapanSearch for more papers by this authorKazuyoshi Namba
Japan Somnology center, Neuropsychiatric Research Institute, Tokyo, Japan
Search for more papers by this authorTakashi Munezawa
Japan Somnology center, Neuropsychiatric Research Institute, Tokyo, Japan
Search for more papers by this authorMasato Matsuura MD, PhD
Department of Life Sciences and Bio-informatics, Graduate School of Allied Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Search for more papers by this authorAbstract
This study was done to identify the clinical characteristics of uremic restless legs syndrome (RLS). Consecutive uremic RLS patients (n = 15) and idiopathic RLS patients (iRLS; n = 20) were evaluated. The groups were compared with respect to their clinical course, subjective symptoms [using the Pittsburgh Sleep Quality Index (PSQI) and the International Restless Legs Syndrome Severity Scale (IRLS)], polysomnographic (PSG) variables, the results of the suggested immobilization test (SIT), and the drug doses used to treat RLS. The duration of the disorder was significantly shorter in the uremic RLS group than in the iRLS group. The PSQI and IRLS scores before treatment were higher in the uremic RLS group than in the iRLS group. The periodic leg movement index (PLM index) on PSG and the SIT index were also higher in the uremic RLS group (P < 0.001, respectively). The bromocriptine equivalent dose of dopaminergic agonists used to treat RLS was significantly higher in the uremic RLS group (P < 0.001). Uremic RLS appears to deteriorate faster and to become more severe than iRLS. Moreover, uremic RLS patients appear to have a decreased response to dopaminergic agonists. © 2007 Movement Disorder Society
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REFERENCES
- 1 Ekbom KA. Restless legs. A clinical study. Acta Med Scand 1945; 158 (Suppl): 1–123.
- 2 Allen RP, Earley CJ. Restless legs syndrome: a review of clinical and pathophysiologic features. J Clin Neurophysiol 2001; 18: 128–147.
- 3 Manconi M, Govoni V, De Vito A, et al. Pregnancy as a risk factor for restless legs syndrome. Sleep Med 2004; 5: 305–308.
- 4 Nomura T, Inoue Y, Miyake M, et al. Prevalence and clinical characteristics of restless legs syndrome in Japanese patients with Parkinson's disease. Mov Disord 2006; 21: 380–384.
- 5 Winkelman JW, Chartow GM, Lazarus M. Restless legs syndrome in end-stage renal disease. Am J Kidney Dis 1996; 28: 372–378.
- 6 Bhowmik D, Bhatia M, Gupta S, et al. Restless legs syndrome in haemodialysis patients in India: a case controlled study. Sleep Med 2003; 4: 143–146.
- 7 Hui D, Wng T, Ko F, et al. Prevalence of sleep disturbances in Chinese patients with end-stage renal failure on continuous ambulatory peritoneal dialysis. Am J Kidney Dis 2000; 36: 783–788.
- 8 Kawauchi A, Inoue Y, Hashimoto T, et al. Restless legs syndrome in hemodialysis patients: health-related quality of life and laboratory data analysis. Clin Nephrol 2006; 66: 440–446.
- 9 Gigli GL, Adorati M, Dolso P, et al. Restless legs syndrome in end-stage renal disease. Sleep Med 2004; 5: 309–315.
- 10 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.
- 11 Wetter TC, Stiasny K, Kohnen R, et al. Polysomnographic sleep measures in patients with uremic and idiopathic restless legs syndrome. Mov Disord 1998; 13: 820–824.
- 12 Wetter TC, Stiasny K, Winkelmann J, et al. A randomized controlled study of pergolide in patients with restless legs syndrome. Neurology 1999; 52: 944–950.
- 13 Pieta J, Millar T, Zacharias J, et al. Effect of pergolide on restless legs and leg movements in sleep in uremic patients. Sleep 1998; 6: 617–622.
- 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.
- 15 Doi Y, Minowa M, Uchiyama M, et al. Development of the Pittsburgh Sleep Quality Index Japanese version. Jpn J Psychiatr Treat 1998; 13: 755–763.
- 16 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.
- 17 Montplasir J, Boucher S, Nicolas A, et al. Immobilization tests and periodic leg movements in sleep for the diagnosis of restless legs syndrome. Mov Disord 1998; 13: 324–329.
- 18 EEG Arousal: scoring rules and examples: a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association. Sleep 1992; 15: 173–184.
- 19 American Academy of Sleep Medicine. International classification of sleep disorders: Diagnostic and coding manual, 2nd ed. Westchester, IL: American Academy of Sleep Medicine; 2005.
- 20 Zucconi M, Ferri R, Aleen RP, et al. The official world association of sleep medicine(WASM) standards for recording and scoring periodic leg movements in sleep(PLMS) and wakefulness(PLMW) developed in collaboration with a task force from the international restless legs syndrome study group(IRLSSG). Sleep Med 2006; 7: 175–183.
- 21 Michaud M, Poirier G, Lavigne G, et al. Restless legs syndrome: scoring criteria for leg movements recorded during the suggested immobilization test. Sleep Med 2001; 2: 317–321.
- 22 Michaud M, Lavigne G, Desautels A, et al. Effects of immobility on sensory and motor symptoms of restless legs syndrome. Mov Diord 2002; 17: 112–115.
- 23 Hasegawa K. The new parkinson's disease drugs. Nippon Rinsho 2000; 58: 2066–2071.
- 24 Winkelman J, Wetter TC, Collado-Seidel V, et al. Clinical characteristics and frequency of the hereditary restless legs syndrome in a population of 300 patients. Sleep 2000; 23: 597–602.
- 25 Rijisman RM, Weerd AW, Stam CJ, et al. Periodic limb movement disorder and restless legs syndrome in dialysis patients. Nephrology 2004; 9: 353–361.
- 26 Aksu M, Demirci S, Bara-Jimenez W. Correlation between putative indicators of primary restless legs syndrome severity. Sleep Med 2007; 8: 84–89.
- 27 Pellecchia MT, Vitale C, Sabatini M, et al. Ropinirole as a treatment of restless legs syndrome in patients on chronic hemodialysis. Clin Neuropharmacol 2004; 27: 178–181.
- 28
Earley CJ,
Conner JR,
Beard JL, et al.
Abnormalities in CSF concentrations of ferritin and transferring in restless legs syndrome.
Neurology
2000;
54:
1968–1700.
10.1212/WNL.54.8.1698 Google Scholar
- 29 Allen RP, Barker PB, Wehrl F, et al. MRI measurement of brain iron in patients with restless legs syndrome. Neurology 2001; 56: 263–265.
- 30 Sloand JA, Shelly MA, Feigin A, et al. A double-blind, placebo-controlled trial of intravenous iron dextran therapy in patients with ESRD and restless legs syndrome. Am J Kidney Dis 2004; 43: 663–670.
- 31 O'Keeffe ST, Gavin K, Lavan JN. Iron status and restless legs syndrome in the elderly. Age Ageing 1994; 23: 200–203.
