Family recurrence and oligo-anuria predict uremic restless legs syndrome

Pizza F, Persici E, La Manna G, Campieri C, Plazzi G, Carretta E, Cappuccilli ML, Ferri B, Stefoni S, Montagna P. Family recurrence and oligo-anuria predict uremic restless legs syndrome. Acta Neurol Scand: 2012: 125: 403–409. © 2011 John Wiley & Sons A/S. Objectives –  To determine clinical and laboratory predictors of restless legs syndrome (RLS) in patients with end-stage kidney disease (ESKD) undergoing long-term hemodialysis (HD). Materials and Methods –  One hundred and sixty-two consecutive patients were assessed. History of sleep disturbances, neurological examination, clinical, and laboratory data were collected. Patients with and without RLS were compared, and a logistic regression model described the relations between independent predictors and RLS. Results –  Fifty-one patients (32%) currently had RLS (RLS+). RLS+ vs RLS− patients were more frequently women (49% vs 29%, P = 0.012), had first-degree relative with RLS (22% vs 6%, P = 0.004), insomnia (59% vs 36%, P = 0.007), peripheral neuropathy (41% vs 21%, P = 0.006), and low residual diuresis (92% vs 68% with below 500 ml/24 h, P = 0.001). Low (OR = 8.71, CI = 2.27–33.41; P = 0.002) and absent (OR = 4.96, CI = 1.52–16.20; P = 0.008) residual diuresis, peripheral neuropathy (OR = 4.00, CI = 1.44–11.14; P = 0.008), and first-degree relative with RLS (OR = 3.82, CI = 1.21–12.13; P = 0.023) significantly predicted RLS in ESKD patients undergoing HD. Conclusion –  Positive family history for RLS together with reduced/absent residual renal function and peripheral neuropathy predicts the risk for RLS in ESKD patients undergoing HD. Longitudinal studies are warranted to correlate RLS occurrence with genetic and environmental factors.