title: Periodic limb movements in sleep are associated with stroke and cardiovascular risk factors in patients with renal failure.
abstract: Periodic limb movements in sleep (PLMS) is prevalent among dialysed patients and is associated with increased risk of mortality. Our study aimed to determine the prevalence of this disease in a sample of transplanted and waiting-list haemodialysed patients. One hundred transplanted and 50 waiting-list patients underwent polysomnography. Moderate and severe diseases were defined as periodic limb movements in sleep index (PLMSI) higher than 15 and 25 events h(-1), respectively. The 10-year coronary heart disease risk was estimated for all patients using the Framingham Score. Moreover, the 10-year estimated risk of stroke was calculated according to the modified version of the Framingham Stroke Risk Profile. PLMS was present in 27% of the transplanted and 42% of the waiting-list group (P = 0.094); the proportion of severe disease was twice as high in waiting-list versus transplanted patients (32 versus 16%, P = 0.024). Patients with severe disease had a higher 10-year estimated risk of stroke in the transplanted group [10 (7-17) versus 5 (4-10); P = 0.002] and a higher 10-year coronary heart disease risk in both the transplanted [18 (8-22) versus 7 (4-14); P = 0.002], and the waiting-list groups [11 (5-18) versus 4 (1-9); P = 0.032]. In multivariable linear regression models the PLMSI was associated independently with the Framingham cardiovascular and cerebrovascular scores after adjusting for important covariables. Higher PLMSI is an independent predictor of higher cardiovascular and cerebrovascular risk score in patients with chronic kidney disease. Severe PLMS is less frequent in kidney transplant recipients compared to waiting-list dialysis patients.
authors.affiliation: Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Anett
authors.initials: A
authors.lastname: Lindner
authors.forename: Katalin
authors.initials: K
authors.lastname: Fornadi
authors.forename: Alpar S
authors.initials: AS
authors.lastname: Lazar
authors.forename: Maria E
authors.initials: ME
authors.lastname: Czira
authors.forename: Andrea
authors.initials: A
authors.lastname: Dunai
authors.forename: Rezso
authors.initials: R
authors.lastname: Zoller
authors.forename: Orsolya
authors.initials: O
authors.lastname: Veber
authors.forename: Andras
authors.initials: A
authors.lastname: Szentkiralyi
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Kiss
authors.forename: Eva
authors.initials: E
authors.lastname: Toronyi
authors.forename: Istvan
authors.initials: I
authors.lastname: Mucsi
authors.forename: Marta
authors.initials: M
authors.lastname: Novak
authors.forename: Miklos Z
authors.initials: MZ
authors.lastname: Molnar
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000503:physiopathology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D006435:Renal Dialysis; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology*; D013997:Time Factors; D014850:Waiting Lists