Restless legs syndrome is associated with cardio/cerebrovascular events and mortality in end-stage renal disease
Journal
European Journal of Neurology
Journal Volume
22
Journal Issue
1
Pages
142-149
Date Issued
2015
Author(s)
Lin C.-H.
Sy H.-N.
Chang H.-W.
HORNG-HUEI LIOU
Lin C.-Y.
Chang C.-C.
Chang C.-C.
Chiu P.-F.
Lin S.-Y.
Abstract
Background and purpose: Earlier studies suggested an association between idiopathic restless legs syndrome (RLS) and cardiovascular diseases. However, the risk of cardiovascular events in patients with secondary RLS due to end-stage renal disease (ESRD) is unclear. Our aim was to examine whether ESRD patients with RLS had an increased risk of cardio/cerebrovascular events and mortality. Methods: In all, 1093 ESRD patients were recruited between 2009 and 2010. The diagnosis and severity of RLS were assessed in a face-to-face interview. The occurrence of cardio/cerebrovascular events and death were confirmed by medical record review. The association between RLS and the outcomes of interest was examined using an adjusted multivariate Cox regression model. Results: After a mean follow-up period of 3.7 ± 0.8 years, ESRD patients with RLS had a significantly higher risk of developing cardiovascular events and strokes [adjusted hazard ratio (aHR) 2.82, 95% confidence interval (CI) 2.02-4.11, and aHR 2.41, 95% CI 1.55-3.75, respectively] compared with patients without RLS. Increasing RLS severity was associated with an increasing likelihood of cardiovascular events [mild RLS severity, aHR 1.71 (95% CI 1.02-2.87); moderate, 2.79 (1.64-4.66); severe, 2.85 (1.99-4.46)] and strokes [mild, 1.89 (0.87-4.16); moderate, 2.42 (1.50-3.90); severe, 2.64 (1.49-4.91)] in a dose-dependent manner. RLS also increased the risk of total mortality in patients with ESRD [aHR 1.53 (95% CI 1.07-2.18), P = 0.02]; this association attenuated slightly after stratification by individual RLS severity category [mild RLS severity, aHR 1.44 (95% CI 0.78-2.67); moderate, 1.49 (0.98-2.55); severe, 2.03 (0.93-4.45)]. Conclusions: ESRD patients with RLS demonstrated an increased likelihood of cardio/cerebrovascular events and mortality. ? 2014 EAN.
SDGs
Other Subjects
adult; Article; cardiovascular disease; cardiovascular risk; cerebrovascular accident; cerebrovascular disease; death; disease severity; end stage renal disease; event free survival; female; follow up; hemodialysis patient; human; interview; major clinical study; male; medical record review; mortality; priority journal; prospective study; restless legs syndrome; sensitivity analysis; aged; Cardiovascular Diseases; Cerebrovascular Disorders; comorbidity; complication; Kidney Failure, Chronic; middle aged; mortality; restless legs syndrome; severity of illness index; Aged; Cardiovascular Diseases; Cerebrovascular Disorders; Comorbidity; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Restless Legs Syndrome; Severity of Illness Index
Publisher
Blackwell Publishing Ltd
Type
journal article