Demet DEMİRCİOĞLU TEKDÖŞ, GÜLİS KAVADAR, Özgül ÖRE ESEN, TULUHAN YUNUS EMRE, Umut YAKA

Relationship between restless leg syndrome and quality of life in uremic patients

Amaç: Huzursuz bacak sendromu (HBS) ağrı, dinlendirici olmayan uyku, gündüz uyku hali ve konsantrasyon bozuklukları yaratan bir hastalıktır. Düzenli hemodiyalize giren son dönem böbrek yetersizliği olan hastalarda huzursuz bacak sendromunun sıklığının artmış olabileceği düşünülmektedir. Bu çalışmada düzenli hemodiyalize giren hastalarda huzursuz bacak sendromu ve yaşam kalitesi arasındaki ilişkinin araştırılması amaçlandı. Gereç ve Yöntem: Türk Böbrek Vakfı Diyaliz Ünitesine ayaktan başvuran 118 kronik hemodiyaliz hastası değerlendirildi. Ulusla- rarası Huzursuz Bacak Sendromu Çalışma Grubunun (IRLSSG) belirlediği tanı kriterlerne uyan 49 hasta çalışmaya dahil edildi. Huzursuz bacak sendromu sempromlarının şiddeti Uluslararası Huzursuz Bacak Sendromu Sınıfama Skalası (IRLS) kullanılarak değerlendirildi. Yaşam kalitesini değerlendirmek amacıyla KısaForm-36 (KF-36) ölçeği kullanıldı. Hastaların demografk özellikleri, komorbid hastalıkları ve laboratuvar verileri kaydedildi. İstatistiksel analizde SPSS paket program kullanıldı. Bulgular: Uluslararası Huzursuz Bacak Sendromu Çalışma Grubu tanı ölçütlerini karşılayan 26 kadın 23 erkek toplam 49 hasta çalışmaya dahil edildi. Hastaların yaş ortalaması 61.35±13.17 yıldı. IRLS skoru ile KF-36 Fiziksel, Zihinsel ve Toplam skorlar arasında istatistiksel açısından anlamlı negatif korelasyon saptandı (p=0.018 r=-0.351, p=0.01 r=-0.380, p=0.00 r=-0.499). IRLS skoru ile diyaliz süresi, yaş, serum ferritin, PTH ve komormid hastalıklar ile anlamlı ilişki bulunmadı p>0.05). Sonuç: Huzursuz bacak sendromu diyalize giren son dönem hastalarda sık rastlanan bir sorun olduğu düşünülmektedir. Huzursuz ba- cak sendromuna bağlı ağrı ve diğer semptomların son dönem böbrek yetersizlikli hastaların yaşam kalitesini kötü yönde etkileyebileceği düşünülerek bu yakınmalara yönelik tanı ve tedavi yaklaşımları bu hastaların yaşam kalitelerinin artırılmasına katkıda bulunacaktır.

Üremik hastalarda huzursuz bacak sendromu ve yaşam kalitesi arasındaki ilişki

Objectives: Patients with RLS sufer nonrestorative sleep, daytime sleepiness, fatigue, and concentration problems. In addi- tion, dialysis itself efects the psychological and social life of the patient negatively. Te aim of this study was to determine the prevalence of RLS in patients on regular hemodialysis, and its relationship with patients quality of life, socio-demographic and laboratory data. Methods: One hundred and eighteen stable chronic hemodialysis (HD) patients referring to the hemodialysis unit of Turkish Kidney Foundation and 49 patients that met IRLSSG diagnostic criteria were included into the study. IRLSSG Diagnostic Criteria and International Restless Leg Syndrome rating scale were used as a guideline to diagnose and evaluate the severity of RLS. Short form-36 health survey was used to evaluate the quality of life. For statistical analysis, the SPSS for Windows package program was used. Results: A total of forty-nine patients, of whom 26 were female and 23 were male, that met IRLSSG diagnostic criteria were included into the study. Mean age of the patients was 61.35±13.17 years. Tere was a negative correlation between the IRLSS score and SF36 Physical Score, Mental Score and Total Score, respectively (p=0.018 r=-0.351, p=0.01 r=-0.380, p=0.00 r=-0.499). Tere was no signifcant correlation between the IRLSS score and dialysis duration, blood ferritin and parathyroid hormone and other comorbid diseases. Conclusion: RLS is a common distressing problem in patients with ESRD, which negatively impacts functional health status. Clinicians should be aware of the symptoms of RLS to decrease morbidities related with quality of life.

PDF

___

1. Restless legs syndrome: detection and management in pri- mary care. National Heart, Lung, and Blood Institute Work- ing Group on Restless Legs Syndrome. Am Fam Physician 2000;62(1):108-14.
2. Bhatia M, Bhowmik D. Restless legs syndrome in main - tenance haemodialysis patients. Nephrol Dial Transplant 2003;18(1):217.
3. S abbatini M, Minale B, Crispo A. Insomnia in mainte - nance haemodialysis patients. Nephrol Dial Transplant 2005;20(3):571-7.
4. M erlino G, Serafni A, Robiony F, Valente M, Gigli GL. Restless legs syndrome: diferential diagnosis and management with rotigotine. Neuropsychiatr Dis Treat 2009;5:67-80.
5. Al-Jahdali HH, Al-Qadhi WA, Khogeer HA, Al-Hejaili FF, Al- Ghamdi SM, Al Sayyari AA. Restless legs syndrome in patients on dialysis. Saudi J Kidney Dis Transpl 2009;20(3):378-85.
6. Chan R, Brooks R, Erlich J, Chow J, Suranyi M. The efects of kidney-disease-related loss on long-term dialysis patients depression and quality of life: positive afect as a mediator. Clin J Am Soc Nephrol 2009;4(1):160-7.
7. F an SL, Sathick I, McKitty K, Punzalan S. Quality of life of caregivers and patients on peritoneal dialysis. Nephrol Dial Transplant 2008;23(5):1713-9.
8. Koç yiğit H, Aydemir Ö, Ozgur B. Kısa Form-36 (KF-36)nın Türkçe versiyonunun güvenilirliği ve geçerliliği. Ilaç ve Tedavi Dergisi 12(2):102-6
9. O Keefe ST, Gavin K, Lavan JN. Iron status and restless legs syndrome in the elderly. Age Ageing 1994;23(3):200-3.
10. Harris DC, Chapman JR, Stewart JH, Lawrence S, Roger SD. Low dose erythropoietin in maintenance haemodialysis: improvement in quality of life and reduction in true cost of haemodialysis. Aust N Z J Med 1991;21(5):693-700.
11. Sloand JA, Shelly M A, Feigin A, Bernstein P, Monk RD. A double-blind, placebo-controlled trial of intravenous iron dextran therapy in patients with ESRD and restless legs syn- drome. Am J Kidney Dis 2004;43(4):663-70.
12. M iranda M, Araya F, Castillo JL, Durán C, González F, Arís L. Restless legs syndrome: a clinical study in adult general pop- ulation and in uremic patients. [Article in Spanish] Rev Med Chil 2001;129(2):179-86. [Abstract]
13. Unruh ML, Levey AS, DAmbrosio C, Fink NE, Powe NR, Meyer KB. Restless legs symptoms among incident dialysis patients: association with lower quality of life and shorter survival. Am J Kidney Dis 2004;43(5):900-9. 14. Collado-Seidel V, Kohnen R, Samtleben W, Hillebrand GF, Oertel WH, Trenkwalder C. Clinical and biochemical fndings in uremic patients with and without restless legs syndrome. Am J Kidney Dis 1998;31(2):324-8.
15. Earley CJ, Silber MH. Restless legs syndrome: understanding its consequences and the need for better treatment. Sleep Med 2010;11(9):807-15.
16. 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(3):c155-60.
17. Tanaka M, Yamazaki S, Hayashino Y, Fukuhara S, Akiba T, Saito A, et al. Hypercalcaemia is associated with poor mental health in haemodialysis patients: results from Japan DOPPS. Nephrol Dial Transplant 2007;22(6):1658-64.
18. M ingardi G, Cornalba L, Cortinovis E, Ruggiata R, Mosconi P, Apolone G. Health-related quality of life in dialysis patients. A report from an Italian study using the SF-36 Health Survey. DIA-QOL Group. Nephrol Dial Transplant 1999;14(6):1503-10.
19. Klersy C, Callegari A, Giorgi I, Sepe V, Efcace E, Politi P; Pavia Working Group on QoL in Organ Transplant. Italian translation, cultural adaptation and validation of KDQOL-SF, version 1.3, in patients with severe renal failure. J Nephrol 2007;20(1):43-51.
20. Kovacs AZ, Molnar MZ, Szeifert L, Ambrus C, Molnar-Varga M, Szentkiralyi A, et al. Sleep disorders, depressive symptoms and health-related quality of life-a cross-sectional compari- son between kidney transplant recipients and waitlisted patients on maintenance dialysis. Nephrol Dial Transplant 2011;26(3):1058-65.
21. S alas RE, Gamaldo CE, Allen RP. Update in restless legs syn - drome. Curr Opin Neurol 2010;23(4):401-6.