title: Relationships Between Malnutrition, Inflammation, Sleep Quality, and Restless Legs Syndrome in Hemodialysis Patients.
abstract: Restless legs syndrome (RLS) is a common neurologic sensorimotor disorder. It is also seen in hemodialysis patients in whom the mechanism is not thoroughly understood. The aim of this study was to evaluate the association between malnutrition-inflammation score (MIS), sleep quality, and RLS in chronic hemodialysis patients. This cross-sectional study included 232 adult stable chronic hemodialysis patients (mean age 60.9 ± 14.1 years, 56.5% male). RLS frequency, MIS, Pittsburgh Sleep Quality Index (PSQI), laboratory data of patients as well as severity of RLS were evaluated. Thirty-seven patients (15.9%) were diagnosed with RLS. Mean MIS of patients with or without RLS were similar. PSQI of patients with RLS was significantly higher than patients without RLS (P = 0.002). There was a significant positive correlation between RLS severity and PSQI (r = 0.445, P = 0.006). A significant positive correlation was also found between PSQI and MIS in patients with RLS (r = 0.419, P = 0.010). RLS severity was positively correlated with some inflammatory parameters such as white blood cell count and C-reactive protein (r = 0.427, P = 0.008 and r = 0.418 P = 0.010). PSQI was found as an independent significant predictor of RLS (odds ratio [OR] = 1.15 (1.06-1.25), P = 0.001) in multivariate logistic regression analysis. Our study revealed that there was no significant relationship between RLS and MIS in chronic hemodialysis patients. However, RLS severity is correlated with inflammatory parameters. Also, sleep quality in chronic hemodialysis patients with RLS is negatively associated with MIS.
authors.affiliation: Department of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Tezcan
authors.initials: T
authors.lastname: Kaya
authors.affiliation: Department of Neurology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Bilgehan Atılgan
authors.initials: BA
authors.lastname: Acar
authors.affiliation: Department of Nephrology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Savaş
authors.initials: S
authors.lastname: Sipahi
authors.affiliation: Department of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Cinemre
authors.affiliation: Department of Neurology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
authors.forename: Türkan
authors.initials: T
authors.lastname: Acar
authors.affiliation: Department of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Ceyhun
authors.initials: C
authors.lastname: Varım
authors.affiliation: Department of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Tamer
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications*; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000150:complications*; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects; D012148:Restless Legs Syndrome / Q000209:etiology*; D012890:Sleep
chemical_list: D002097:C-Reactive Protein
keywords: Hemodialysis; Inflammation; Malnutrition; Nutrition assessment; Restless legs syndrome