Clinical and psychological aspects of restless legs syndrome in uremic patients on hemodialysis.
BACKGROUND
The pathogenesis of restless legs syndrome (RLS) is still unclear. The purpose of this study is to determine relationships of the presence of RLS in uremic patients regularly undergoing hemodialysis (HD) with demographic, clinical, and psychological factors.


METHODS
In 490 uremic patients on HD therapy in Japan, RLS was diagnosed based on diagnostic criteria established by the International Restless Legs Syndrome Study Group. Data were compared between patients with and without RLS.


RESULTS
There were univariately significant (P < 0.05) differences in serum phosphorus levels, anxiety levels determined using the Hospital Anxiety and Depression Scale, and degrees of emotion-oriented and avoidance-oriented coping determined using the Coping Inventory for Stressful Situations. In multivariate analyses, low hemoglobin levels, high serum phosphorus levels, high anxiety levels, and a great degree of emotion-oriented coping were independently related to the presence of RLS in uremic patients on HD therapy, with statistical significance (P < 0.05).


CONCLUSIONS
Hyperphosphatemia, anxiety, and a great degree of emotion-oriented coping with stress were independently related to the presence of RLS in uremic patients on HD therapy. The pathogenesis of RLS seems to involve more than one mechanism, which leads to restless legs as the final common pathway. These findings may provide new clues to the pathogenesis of RLS.
Takaki
Jiro
J
Department of Psychosomatic Medicine, Tokyo University Hospital, Faculty of Medicine, University of Tokyo, Tokyo Japan. jirosinryounaika-tky@umin.ac.jp
Nishi
Tadahiro
T
Nangaku
Masaomi
M
Shimoyama
Hiromi
H
Inada
Toshio
T
Matsuyama
Norimasa
N
Kumano
Hiroaki
H
Kuboki
Tomifusa
T
D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety / Q000209:etiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D018491:Dopamine Agonists / Q000494:pharmacology / Q000627:therapeutic use; D004644:Emotions; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood*; D006435:Renal Dialysis; D012148:Restless Legs Syndrome / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D014511:Uremia / Q000097:blood / Q000150:complications* / Q000523:psychology / Q000628:therapy
D018491:Dopamine Agonists; D006454:Hemoglobins; D010710:Phosphates