title: Association between restless legs syndrome and depression in patients with chronic kidney disease.
abstract: Restless legs syndrome (RLS) is reportedly associated with depression. This association may be mediated by both sleep-dependent and sleep-independent mechanisms. Here we analyze the association between RLS and depressive symptoms in patients with chronic kidney disease (CKD). We also assessed whether the relationship is independent of insomnia. In a cross-sectional study, socio-demographic parameters, laboratory data, and medical history were collected from 788 kidney transplant patients and 161 dialyzed patients. Insomnia, depression, and the presence of RLS symptoms were assessed with standard questionnaires. Patients with probable RLS had a higher prevalence of depressive symptoms than those without RLS (56% vs. 22% with vs. without RLS, respectively; P<.001). Patients presenting RLS symptoms had higher Athens Insomnia Scale (AIS) scores than patients without RLS [median AIS score (interquartile range): 7 (6) vs. 3 (4) with vs. without RLS, respectively; P<.001]. The AIS score correlated with the CES-D score (Spearman's rho=0.54, P<.001). In multivariate analysis, the presence of RLS symptoms was independently associated with depressive symptoms (OR=3.96, 95% CI 2.21-7.1, P<.001). This relationship remained significant even after including insomnia in the model (OR=2.9, CI 1.55-5.43, P<.001). The presence of RLS symptoms is associated with depression in patients with CKD. This relationship remained significant even after accounting for insomnia. Sleep-independent mechanisms may also contribute to the association between RLS and depression in patients with CKD.
authors.affiliation: Institute of Behavioral Sciences, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Andras
authors.initials: A
authors.lastname: Szentkiralyi
authors.forename: Miklos Zsolt
authors.initials: MZ
authors.lastname: Molnar
authors.forename: Maria Eszter
authors.initials: ME
authors.lastname: Czira
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Deak
authors.forename: Anett Virag
authors.initials: AV
authors.lastname: Lindner
authors.forename: Lilla
authors.initials: L
authors.lastname: Szeifert
authors.forename: Peter
authors.initials: P
authors.lastname: Torzsa
authors.forename: Eszter Panna
authors.initials: EP
authors.lastname: Vamos
authors.forename: Rezso
authors.initials: R
authors.lastname: Zoller
authors.forename: Istvan
authors.initials: I
authors.lastname: Mucsi
authors.forename: Marta
authors.initials: M
authors.lastname: Novak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult