CLINICAL AND BIOCHEMICAL FINDINGS IN UREMIC PATIENTS WITH AND WITHOUTRESTLESS LEGS SYNDROME

The restless legs syndrome (RLS) is one of the most common and unpleas ant complaints of uremic patients, The pathophysiology of the RLS is s till unclear, Various factors, including anemia and iron deficiency, a re proposed to play a major role, We determined the prevalence of RLS in all stable hemodialysis patients under long-term treatment in two d ialysis centers(n = 136) and compared the clinical and biochemical fin dings of patients with RLS and without RLS. Twenty-three percent of al l patients investigated fulfilled the diagnostic criteria of RLS accor ding to the International Restless Legs Syndrome Study Group, There we re no statistical differences between the two groups regarding age, du ration of uremia and need for dialysis, time on dialysis per week, hem oglobin, hematocrit, erythrocytes, s-ferritin, s-transferrin, s-iron, calcium, and standard biochemical indices, except for intact parathyro id hormone (iPTH) levels. Uremic patients with RLS showed significantl y lower iPTH (P < 0.01) concentrations. In addition, the RLS group rec eived a significantly higher number and dosage of psychopharmacologica l drugs, tie, L-DOPA), than patients without RLS, These biochemical fi ndings suggest that neither the severity of anemia nor that of iron de ficiency has to be considered a major pathophysiological factor in est ablished RLS, The significantly lower iPTH secretion in uremic patient s with RLS, however, is a new finding, and further investigations will be necessary to determine whether this result Is of any clinical sign ificance to this group of patients, The significantly higher number of psychopharmacological drugs prescribed to uremic patients with RLS ma y be related to the symptoms of RLS. (C) 1998 by the National Kidney F oundation, Inc.