Li-Yan Zhang, 1,* Xiao-Yang Ma, 2,* Jun Lin, 3 Wen-Hu Liu, 4 Wang Guo, 4 Le Yin, 4 Shi-Xiang Wang, 3 Xia Li, 5 Jing Li, 5 Li-Li Jin, 6 Ze-Long Tian, 7 Yi-Tong Du, 1 Hou-Zhen Tuo 1

1Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, Peoples Republic of China; 2Department of Neurology, Beijing Ditan Hospital, Capital Medical University, Beijing, Peoples Republic of China; 3Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, Peoples Republic of China; 4Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, Peoples Republic of China; 5Blood Purification Center, Beijing No. 6 Hospital, Beijing, Peoples Republic of China; 6Department of Nephrology, Beijing Zhongxing Hospital, Beijing, Peoples Republic of China; 7Department of Neurology, Tianjin 4th Central Hospital, Tianjin, Peoples Republic of China

*These authors contributed equally to this work

Correspondence: Hou-Zhen TuoDepartment of Neurology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100051, Peoples Republic of ChinaTel/Fax +86 10-63139807Email tuohzh@sina.cn

Objective: The current study aimed to investigate the prevalence and risk factors of restless legs syndrome (RLS) in patients undergoing hemodialysis, as well as the mortality and risks of cardiovascular and cerebrovascular events.Methods: A total of 354 hemodialysis patients from four hospitals were enrolled. RLS was diagnosed using the International RLS Study Group (IRLSSG) criteria. The patients were evaluated face-to-face using the IRLSSG rating scale, Epworth Sleepiness Scale (ESS), Hamilton Anxiety Scale, Hamilton Depression Scale, and Pittsburgh Sleep Quality Index (PSQI). The patients were followed up for 9 months. Death was considered an endpoint event. The cardiovascular and cerebrovascular events were investigated.Results: The prevalence of RLS in hemodialysis patients was 40.7% and was associated with factors such as duration of hemodialysis, hypersensitive C-reactive protein, hyperparathyroidism, glycosylated serum protein, and erythropoietin treatment. The scores of the PSQI, ESS, and Hamilton Depression Scale in the RLS group were significantly higher than those in the non-RLS group (p < 0.05). During follow-ups, the incidence rate of cardiovascular diseases was 18.8% in the RLS group and 8.6% in the non-RLS group (p < 0.005). The IRLSSG rating scores were significantly higher in RLS patients with kidney transplantation failure compared with those without transplantation (p < 0.05).Conclusion: The prevalence of RLS was high in hemodialysis patients. The risk factors of RLS included duration of hemodialysis, hypersensitive C-reactive protein, hyperparathyroidism, glycosylated serum protein, and erythropoietin treatment. RLS affected sleep quality and emotion and increased the risk of cardiovascular diseases in hemodialysis patients. RLS was more severe in patients with kidney transplantation failure compared with those without transplantation.

Keywords: restless legs syndrome, hemodialysis, prevalence, risk factor, cardiovascular disease

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