title: Effect of the antiplatelet agent cilostazol on endovascular inflammatory biochemical parameters and the clinical symptoms of peripheral artery disease and restless legs syndrome in hemodialysis patients.
abstract: BACKGROUND
  Peripheral artery disease (PAD) is a common complication in patients receiving hemodialysis (HD). Cilostazol is used for the treatment of ischemic symptoms in patients with PAD, based on its antiplatelet and vasodilating effects. In addition to these beneficial effects on clinical symptoms in PAD patients, cilostazol has been proposed to have additional effects on clinical symptoms in patients with restless legs syndrome (RLS) via the upregulation of dopamine. We performed an observational, prospective study to evaluate the effect of cilostazol on several clinical and biochemical parameters in HD patients with PAD and RLS.
  
  
  METHODS
  All the study patients received cilostazol treatment for 12 months. During the study period, several biochemical parameters, such as high-sensitivity CRP, von Willebrand antigen (VW-Ag), triglyceride (TG), high-density lipoprotein (HDL) and malondialdehyde-modified low-density lipoprotein, were monitored. A questionnaire on the physical status of PAD and RLS was also completed. 45 HD patients who received cilostazol were compared with a control group of 22 patients.
  
  
  RESULTS
  The patients who continued cilostazol treatment exhibited a improvement in their serum inflammatory and biochemical parameters (VW-Ag, TG, HDL). Although PAD and RLS scores were not improved by multivariate analysis, several patients showed improvement of signs and symptoms which were included in the PAD or RLS scores.
  
  
  CONCLUSIONS
  The treatment of HD patients with cilostazol improved some of the lipid-related and endovascular inflammatory biochemical parameters associated with PAD, and relieved the clinical symptoms and physical status of PAD in some cases.
authors.affiliation: Department of Medicine IV, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku, Tokyo 162-8666, Japan. syunji71@yahoo.co.jp
authors.forename: Shunji
authors.initials: S
authors.lastname: Shiohira
authors.forename: Takumi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Sugiura
authors.forename: Satsuki
authors.initials: S
authors.lastname: Yoshida
authors.forename: Michihiro
authors.initials: M
authors.lastname: Mitobe
authors.forename: Katsunori
authors.initials: K
authors.lastname: Shimada
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohba
authors.forename: Ken
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Takashi
authors.initials: T
authors.lastname: Kabaya
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D000077407:Cilostazol; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007564:Japan; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016491:Peripheral Vascular Diseases / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D012148:Restless Legs Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D011795:Surveys and Questionnaires; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D008055:Lipids; D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077407:Cilostazol