Risk factors of restless leg syndrome in maintenance hemodialysis patients / 第二军医大学学报

ABSTRACT

Objective To investigate the risk factors of restless leg syndrome (RLS) in maintenance hemodialysis patients. Methods The clinical data of 74 maintenance hemodialysis patients in Eastern Hepatobiliary Surgery Hospital of Navy Medical University (Second Military Medical University) from July 2016 to September 2017 were retrospectively analyzed. The gender, age, diabetes mellitus and other biochemical indicators of the patients with or without RLS were compared. The univariate logistic regression analysis was performed with the gender, age, diabetes mellitus and other biochemical indicators as covariates, and the RLS as dependent variable. According to the 2003 International Restless Leg Syndrome Study Group (IRLSSG) criteria, the patients with RLS were divided into mild, moderate, severe and very severe groups, with the patients without RLS as controls; the variables that were significantly different between the groups as analyzed by univariate logistic regression analysis were compared by t-test and multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve for the main relevant factors was plotted, and the area under the curve was calculated to determine the best critical value and the corresponding sensitivity and specificity. Results A total of 74 maintenance hemodialysis patients were enrolled in this study, including 46 males and 28 females; the patients aged from 21 to 87 years, with an average age of (56.70±14.52) years; 55 patients without RLS, and 19 with RLS. The serum calcium in patients with RLS was significantly higher than that without RLS ([2.56±0.38] mmol/L vs [2.26±0.29] mmol/L, t＝2.61, P＝0.02). Multivariate logistic regression analysis showed that serum parathyroid hormone (PTH)515.39 pg/mL was an independent risk factor for RLS in maintenance hemodialysis patients (OR＝1.00, 95% CI 1.00-1.01, P＝0.03). With the cutoff value being 515.39 pg/mL, area under ROC curve performed by PTH for RLS was 0.759, with the 95% CI being 0.610- 0.907, and the sensitivity and specificity being 0.47 and 0.98, respectively. Conclusion RLS is a common complication in maintenance hemodialysis patients. Chronic kidney disease-mineral and bone metabolism disorder may be related to the occurrence of RLS in maintenance hemodialysis patients.