CKD-MBD May Play Role in Restless Legs Syndrome in Dialysis Patients

Phosphate and vitamin D deficiency were linked with RLS severity.
Phosphate and vitamin D deficiency were linked with RLS severity.

SAN DIEGO—Chronic kidney disease mineral and bone disorders (CKD-MBD) may contribute to the development of restless legs syndrome (RLS) in hemodialysis patients, investigators revealed at Kidney Week.

The sleep disorder is common among hemodialysis (HD) patients, and it has been associated with cardiovascular disease and premature death.

Using the International RLS Study Group rating scale, Rosilene M. Elias, MD, PhD, of the University of Sao Paulo in Brazil, and colleagues identified RLS in 28.7% of 129 HD patients. Patients with greater RLS severity tended to be women and those presenting with low serum calcium, higher serum phosphate, lower iron, and a tendency toward lower transferrin saturation.

RLS severity scores were significantly related to the dose of erythropoietin, ionized calcium, serum phosphate, and serum albumin. Serum phosphate and vitamin D deficiency were the main factors associated with severity, according to a model adjusted for iron metabolism, hemoglobin, and gender.

“Besides iron metabolism, CKD-MBD seems to be implicated in the pathophysiology of RLS,” Dr. Elias told Renal & Urology News. “It is plausible that the relationship between RLS and CKD-MBD contributes to the increased mortality risk observed in these patients.” She recommended nephrologists ask hemodialysis patients to complete the international validated questionnaire for RLS diagnosis.

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