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Liu S, Zhang F, Bai Y, Huang L, Zhong Y, Li Y. Therapeutic effects of acupuncture therapy for kidney function and common symptoms in patients with chronic kidney disease: a systematic review and meta-analysis. Ren Fail 2024; 46:2301504. [PMID: 38189090 PMCID: PMC10776068 DOI: 10.1080/0886022x.2023.2301504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 01/09/2024] Open
Abstract
Purpose: The number of clinical reports of acupuncture therapy in chronic kidney disease (CKD) is gradually increasing. This systematic review and meta-analysis aim to examine the therapeutic role of acupuncture therapy in kidney function and common symptoms in CKD patients.Methods: We searched Embase, PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, WanFang, and WeiPu for randomized controlled trials comparing acupuncture treatment with control or placebo groups. We assessed the effect of acupuncture therapy in CKD patients using a meta-analysis with the hartung-knapp-sidik-jonkman random effects model. In addition, we visualized keyword co-occurrence overlay visualization with the help of VOSviewer software to describe the research hotspots of acupuncture therapy and CKD.Results: A total of 24 studies involving 1494 participants were included. Compared to the control group, acupuncture therapy reduced serum creatinine levels (standardized mean difference [SMD]: -0.57; 95% CI -1.05 to -0.09) and relieved pruritus (SMD: -2.20; 95% CI -3.84, -0.57) in patients with CKD, while the TSA showed that the included sample size did not exceed the required information size. The included studies did not report acupuncture-related adverse events.Conclusions: Acupuncture is an effective and safe treatment for improving kidney function and relieving pruritic symptoms in patients with CKD, but the very low evidence may limit this conclusion. The TSA suggests that high-quality trials are needed to validate the efficacy of acupuncture therapy.
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Affiliation(s)
- Shan Liu
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fan Zhang
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Bai
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Liuyan Huang
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yifei Zhong
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yi Li
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
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2
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Miyaguchi R, Masuda F, Sumi Y, Kadotani H, Ozeki Y, Banno M, Kuniyoshi Y. Prevalence of depression or depressive state in patients with restless legs syndrome: A systematic review and meta-analysis. Sleep Med Rev 2024; 77:101975. [PMID: 39024776 DOI: 10.1016/j.smrv.2024.101975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 06/19/2024] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
Restless legs syndrome (RLS) is a common sleep-related disorder characterized by limb discomfort and the urge to move them when at rest, especially in the evening or at night. Although depression is often linked to various conditions, no systematic review has assessed depression prevalence in patients with RLS after the latest diagnostic criteria revision. This systematic review and meta-analysis aimed to investigate the depression and depressive state prevalence among patients with RLS. We systematically searched databases up to November 2022 and performed meta-analyses of the depression prevalence using a random-effects model and a meta-regression analysis to explore the relationship between the prevalence and severity of depression and factors such as age and RLS severity. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we analyzed 24 studies with 2039 patients. The pooled depression or depressive state prevalence, mostly defined by questionnaire scores, was 30.39 %. Nine studies reported the proportion of patients taking antidepressants (pooled rate: 3.41 %). No specific factors related to the prevalence or severity of depression were identified in patients with RLS. These findings highlight the significant prevalence of depression and underscore the need for future research with standardized diagnostic interviews and consistent methodologies across multi-site studies.
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Affiliation(s)
- Rin Miyaguchi
- Faculty of Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Fumi Masuda
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Yukiyoshi Sumi
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan; Department of Psychiatry, Nagahama Red Cross Hospital, Shiga, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan.
| | - Yuji Ozeki
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Masahiro Banno
- Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan; Department of Psychiatry, Seichiryo Hospital, Nagoya, Japan
| | - Yasutaka Kuniyoshi
- Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan; Department of Pediatrics, Tsugaruhoken Medical COOP Kensei Hospital, Aomori, Japan
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Chen Y, Wang D, Yin J, Krafft PR, Luo X, Hao D, Li C, Liu Y, Li L, Zhang Y, Zhu C. Increased TMEM166 Level in Patients with Postoperative Stroke after Carotid Endarterectomy. Neuroscience 2024; 549:138-144. [PMID: 38734302 DOI: 10.1016/j.neuroscience.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/21/2024] [Accepted: 05/05/2024] [Indexed: 05/13/2024]
Abstract
Postoperative stroke is a challenging and potentially devastating complication after elective carotid endarterectomy (CEA). We previously demonstrated that transmembrane protein 166 (TMEM166) levels were directly related to neuronal damage after cerebral ischemia-reperfusion injury in rats. In this subsequent clinical study, we aimed to evaluate the prognostic value of TMEM166 in patients suffering from post-CEA strokes. Thirty-five patients undergoing uncomplicated elective CEA and 8 patients who suffered ischemic strokes after CEA were recruited. We evaluated the protein level and expression of TMEM166 in patients diagnosed with postoperative strokes and compared it to those in patients who underwent uncomplicated elective CEA. Blood samples and carotid artery plaques were collected and analyzed. High expressions of TMEM166 were detected by immunofluorescence staining and Western Blot in carotid artery plaques of all patients who underwent CEA. Furthermore, circulating TMEM166 concentrations were statistically higher in post-CEA stroke patients than in patients allocated to the control group. Mean plasma concentrations of inflammatory markers, including interleukin 6 (IL-6) and C-reactive protein (CRP), were also elevated in patients with postoperative strokes. Therefore, based on these findings, we hypothesize that elevated TMEM166 levels, accompanied by a strong inflammatory response, serve as a useful biomarker for risk assessment of postoperative stroke following CEA.
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Affiliation(s)
- Yifei Chen
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Danyang Wang
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jie Yin
- Department of Anesthesiology, the First Affiliated Hospital of Xinxiang Medical University, Henan, China
| | - Paul R Krafft
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Xin Luo
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Dandan Hao
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chengwen Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ye Liu
- Department of Anaesthesiology, Beijing Obstetrics and Gynecology Hospital,Capital Medical University, Beijing, China.
| | - Li Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Yongbo Zhang
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Chen Zhu
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Li L, Krafft PR, Zeng N, Duan R, Qi X, Shao A, Xue F, Zhang JH. Microglia Autophagy Mediated by TMEM166 Promotes Ischemic Stroke Secondary to Carotid Artery Stenosis. Aging Dis 2024; 15:1416-1431. [PMID: 37611898 PMCID: PMC11081158 DOI: 10.14336/ad.2023.0803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023] Open
Abstract
Ischemic stroke can be a serious complication of selective carotid endarterectomy (CEA) in patients with carotid artery stenosis (CAS). The underlying risk factors and mechanisms of these postoperative strokes are not completely understood. Our previous study showed that TMEM166-induced neuronal autophagy is involved in the development of secondary brain injury following cerebral ischemia-reperfusion injury in rats. This current study aimed to investigate the role of TMEM166 in ischemic stroke following CEA. In the clinical part of this study, the quantitative analysis demonstrated circulating TMEM166, interleukin 6 (IL-6), and C-reactive protein (CRP) levels were significantly elevated in patients who suffered an ischemic stroke after CEA compared to those who did not. Furthermore, non-survivors exhibited higher levels of these proteins than survivors. In the preclinical part of this study, a middle cerebral artery occlusion (MCAO) model was implemented following CAS simulation in TMEM166-/- mice. We found TMEM166 expression was positively correlated with the degree of ischemic brain injury. Ad5-TMEM166 transfection aggravated ischemic brain injury by inducing microglial autophagy activation and release of inflammatory cytokines. Accordingly, TMEM166 deficiency reduced brain inflammation and inhibited excessive microglial autophagy through the mammalian target of rapamycin (mTOR) pathway. These findings suggest that TMEM166 may play a key role in the development of ischemic injury after CEA and may serve as a biomarker for risk assessment of postoperative ischemic stroke.
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Affiliation(s)
- Li Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Paul R. Krafft
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, USA.
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China.
| | - Ranran Duan
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Xiang Qi
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China.
| | - Anwen Shao
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
| | - Fushan Xue
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - John H. Zhang
- Department of Anesthesiology, Neurosurgery and Neurology, School of Medicine, Loma Linda University, Loma Linda, CA, USA.
- Department of Physiology and Pharmacology, Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA, USA.
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An T, Sun H, Yuan L, Wu X, Lu B. Associations of anxiety and depression with restless leg syndrome: a systematic review and meta-analysis. Front Neurol 2024; 15:1366839. [PMID: 38562425 PMCID: PMC10982394 DOI: 10.3389/fneur.2024.1366839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
Background The levels of anxiety and depression among patients with restless leg syndrome (RLS) are controversial. The aim of this systematic review and meta-analysis was to compare the levels of depression and anxiety among individuals with RLS with those of healthy controls. Methods We conducted an extensive electronic search of the PubMed, Web of Science, EMBASE, and Cochrane Library databases from their inception dates to 20 June 2023. Studies presenting data on depression and anxiety in individuals with RLS were included, and a comprehensive meta-analysis was performed. Results Twenty-one studies matched the inclusion criteria. Significantly more depressive symptoms were present in the individuals with RLS than in those without RLS, as measured by the Beck Depression Inventory [mean difference (MD) = 6.58, 95% confidence interval (CI) = 5.54-7.62, p < 0.01; heterogeneity I2 = 0%, p = 0.99]. Similarly, the results from the Beck Anxiety Inventory indicated that there were significantly more pronounced anxiety symptoms in the individuals with RLS than in those without RLS (MD = 9.30, 95%CI = 7.65-10.94, p < 0.01; heterogeneity I2 = 0%, p = 0.92). The other anxiety and depression scales also yielded statistically significant results. Significant heterogeneity was observed in the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale, with the primary contributing factor probably being the scoring criteria of the scales. Conclusion This meta-analysis found that the levels of depression and anxiety symptoms were significantly higher in individuals with RLS than in their healthy counterparts.Systematic review registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023410364, (identifier CRD42023410364).
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Affiliation(s)
- Tianyang An
- College of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Haiyang Sun
- Cangzhou Center for Disease Control and Prevention, Cangzhou, Hebei, China
| | - Lu Yuan
- College of Psychology and Mental Health of North China University of Science and Technology, Tangshan, Hebei, China
| | - Xiuling Wu
- Department of Neurology, Tangshan Gongren Hospital, Tangshan, Hebei, China
| | - Baoquan Lu
- Department of Neurology, Tangshan Gongren Hospital, Tangshan, Hebei, China
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Liu Y, Du Q, Jiang Y. Prevalence of restless legs syndrome in maintenance hemodialysis patients: A systematic review and meta-analysis. Sleep Med 2024; 114:15-23. [PMID: 38147712 DOI: 10.1016/j.sleep.2023.11.1138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Restless legs syndrome is associated with quality of life and risk of death in maintenance hemodialysis patients. Although relevant meta-analyses have been conducted, epidemiological studies of restless legs syndrome have increased in recent years. OBJECTIVE Our aim was to systematically assess the prevalence of restless legs syndrome in maintenance hemodialysis patients and to evaluate the effect of different geographic regions, genders, study designs, and years of publication on the prevalence of restless legs syndrome. METHODS PubMed, Web of Science, EMBASE, The Cochrane Library, China Knowledge Resource Integrated Database, Wanfang Database, Weipu, and Chinese Biomedical Database were searched before March 16, 2023 for the published literature. Two investigators independently performed literature screening, data extraction for eligible studies, and risk of bias assessment. A random-effects model using the stata 15.0 software was used to assess the pooled prevalence of restless legs syndrome. RESULTS Fifty-seven articles were included in this meta-analysis, and the pooled prevalence of restless legs syndrome in 12,573 maintenance hemodialysis patients was 24.0 % (95 % CI: 21.0%-26.0 %). Maintenance hemodialysis patients from the Americas region and females had severe symptoms of restless legs syndrome, and the prevalence of restless legs syndrome increased from year to year. The prevalence of restless legs syndrome was higher in maintenance hemodialysis patients in cross-sectional studies and cohort studies compared to case-control studies. CONCLUSIONS Maintenance hemodialysis patients have a significantly higher prevalence of restless legs syndrome. These findings may provide some reference value for hospital nursing staff to focus on the management and treatment of restless legs syndrome in maintenance hemodialysis patients.
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Affiliation(s)
- Yaxin Liu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Qiufeng Du
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Yunlan Jiang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China.
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Zhou X, Liu Y, Zhang X, Wang C, Liu S, Jiang Y. Global prevalence of restless legs syndrome among hemodialysis patients: A systematic review and meta-analysis. Brain Behav 2024; 14:e3378. [PMID: 38376019 PMCID: PMC10784193 DOI: 10.1002/brb3.3378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES Restless legs syndrome (RLS) is a common complaint in patients undergoing hemodialysis (HD). Despite the fact that the estimated prevalence of RLS among HD patients is widely reported, these results varied significantly in the relevant literature. Due to this limitation, the aim of this study was to determine the global prevalence of RLS among HD patients. METHODS This systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 statement. We searched the electronic databases: Cochrane Library, PubMed, Embase, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, China Knowledge Resource Integrated Database, Wanfang Database, Chinese Biomedical Database, and Weipu Database. A random effects model was employed to calculate pooled prevalence rates. RESULTS The global pooled prevalence of RLS in HD patients was 27.2% (95% CI: 24.8-29.7). Stratified analyses demonstrated that included studies with sample size <100 had the highest pooled prevalence of RLS. The prevalence of RLS using clinical interviews and questionnaires was 28.7% (95% CI: 25.2-32.2) and 25.9% (95% CI: 22.8-29.1), respectively. RLS prevalence is higher in females (29.7%, 95% CI: 26.2-33.2) HD patients than in males (23.5%, 95% CI: 20.9-26.0), and the African region has the highest prevalence in the world when the diagnostic criteria were restricted to the 2003 version of International RLS Study Group criteria, the prevalence of RLS was highest (28.9%, 95% CI: 25.9-31.9). CONCLUSION Our results revealed a high RLS prevalence in HD patients worldwide. However, the prevalence of RLS among HD patients varied significantly based on sample size, data collection method, gender, diagnostic criteria, and geographical region.
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Affiliation(s)
- Xu‐Hua Zhou
- Evidence‐Based Nursing Center, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanP. R. China
| | - Yuan Liu
- Evidence‐Based Nursing Center, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanP. R. China
| | - Xin‐Rui Zhang
- Evidence‐Based Nursing Center, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanP. R. China
| | - Cong Wang
- Evidence‐Based Nursing Center, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanP. R. China
| | - Shan‐Shan Liu
- Evidence‐Based Nursing Center, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanP. R. China
| | - Yan Jiang
- Nursing Department, West China HospitalSichuan University/West China School of NursingSichuan UniversityChengduSichuanP. R. China
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Xu J, Qi Y, Tang Y, Zhang W, Zhang Q, Xu L, Ding Z, Liu T. Improvement of restless leg syndrome in maintenance hemodialysis patients with limb ischemic preconditioning: a single-center randomized controlled clinical trial. Ren Fail 2023; 45:2283589. [PMID: 38047534 PMCID: PMC11001338 DOI: 10.1080/0886022x.2023.2283589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023] Open
Abstract
OBJECTIVE This study evaluated the efficacy and safety of limb ischemic preconditioning (LIPC) in treating restless leg syndrome (RLS) in maintenance hemodialysis (MHD) patients. METHODS A total number of 45 patients participated in the study. They were randomly divided into LIPC group and control group. The LIPC was performed by inflating the limb ischemic preconditioning training device in the patient's thigh to 200 mmHg to create transient ischemia, whereas control group inflated the device to 20 mmHg. International Restless Legs Syndrome (IRLS), Clinical Global Impression Scale (CGI-S), and Medical Outputs Study Sleep Scale were employed to evaluate LIPC effectiveness. The primary endpoint was the 'rate of clinical improvement in RLS severity', defined as the percentage of patients who had an IRLS score decrease of ≥5 points in each group. RESULTS After intervention, the rate of clinical improvement in RLS severity was 56.5% in the LIPC group and 13.6% in the control group (13 (56.5) vs 3 (13.6), p = 0.003). In addition, the LIPC group's IRLS, CGI-S scores, the sleep disturbance and somnolence scores showed a significant downward trend compared to the control group (-5.5 ± 5.3 vs - 1.0 ± 3.8, p = 0.002; -1.7 ± 1.2 vs - 0.5 ± 1.4, p = 0.003; -15.5 ± 17.8 vs 3.7 ± 12.0, p < 0.001; -9.9 ± 18.8 vs - 2.4 ± 8.6, p = 0.003). During the study, there were no serious adverse event in any of the patients. CONCLUSIONS LIPC could be employed to effectively and safely alleviate the RLS symptoms in MHD patients.
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Affiliation(s)
- Juntian Xu
- Department of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
- Graduate College, Dalian Medical University, Dalian, China
| | - Yuan Qi
- Department of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
- Graduate College, Dalian Medical University, Dalian, China
| | - Yushang Tang
- Department of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Wanfen Zhang
- Department of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Qiaoyang Zhang
- Department of Psychology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Linfang Xu
- Hemodialysis Center, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Zhongqin Ding
- Hemodialysis Center, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Tongqiang Liu
- Department of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
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The Effect of Mindfulness-Based Stress Reduction on Restless Legs Syndrome in Hemodialysis Patients: A Randomized Clinical Trial. NURSE MEDIA JOURNAL OF NURSING 2022. [DOI: 10.14710/nmjn.v12i3.46307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: There is currently no definitive cure for restless legs syndrome (RLS), and the common treatments are only used to reduce symptoms. Mindfulness-based stress reduction (MBSR) is an intervention that has shown beneficial effects in many mental and physical disorders.Purpose: This study aimed to determine the effect of MBSR on RLS in hemodialysis patients.Methods: This study was a randomized clinical trial involving 60 hemodialysis patients with RLS recruited by convenience sampling each group. Inclusion criteria were patients with RLS diagnosis, age 18-65, Hb>10, no cognitive disorders, ability to read and write, no vision or hearing problems, and history of hemodialysis ≥6 months. The intervention group received eight sessions of the MBSR program, and the control group received routine care in a government dialysis center. International Restless Legs Syndrome Scale and Restless Legs Syndrome Severity Scale were used to measure RLS. Statistical analyses were conducted using independent and pair t-test and ANCOVA.Results: Significant difference was found in the severity the RLS (Mean(SD) score) between the intervention group (12.90(4.58)) and the control group (22.27(4.19)) (95% CI:-11.66 to -7.08, p<0.0001). The effect size between groups was obtained based on Cohen’s d of 2.13.Conclusion: MBSR showed a significant reduction in the severity of RLS in hemodialysis patients. This preliminary study suggests that MBSR can be a promising treatment option in the management of RLS patients.
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Suwała S, Rzeszuto J, Glonek R, Krintus M, Junik R. Is Restless Legs Syndrome De Facto Thyroid Disease? Biomedicines 2022; 10:biomedicines10102502. [PMID: 36289762 PMCID: PMC9599059 DOI: 10.3390/biomedicines10102502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/22/2022] [Accepted: 10/04/2022] [Indexed: 12/01/2022] Open
Abstract
While a primary role in the pathogenesis of restless legs syndrome (RLS) has been attributed to dysfunction of the dopaminergic system and impaired iron metabolism (particularly in the central nervous system), it has been hypothesized that an imbalance between thyroid hormones and dopaminergic activity may be the starting point for all aspects of RLS. Although this hypothesis was proposed more than a decade ago, it has not yet been verified beyond doubt. The main aim of this study is to compare the prevalence of RLS in a population of patients with the most common thyroid gland diseases with a population of individuals with a healthy thyroid gland. The study included 237 participants divided into smaller groups according to the thyroid disease concerning them. Each participant had a laboratory diagnosis, an ultrasound scan and an assessment of the fulfilment of RLS criteria according to the International Restless Legs Syndrome Study Group (IRLSSG) criteria. The results obtained were subjected to statistical analysis. RLS is significantly more common in patients with known thyroid disease; Hashimoto’s disease, among others, manifests a 2.56× higher risk of a positive diagnosis for RLS than the general population. The association of RLS with thyroid disease is notable, although it is difficult to conclude unequivocally that there is a cause-and-effect relationship between the two. Further investigation into a potentially autoimmune cause of restless legs syndrome should be considered.
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Affiliation(s)
- Szymon Suwała
- Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland
- Correspondence:
| | - Jakub Rzeszuto
- Evidence-Based Medicine Students Scientific Club of Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland
| | - Rafał Glonek
- Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland
| | - Magdalena Krintus
- Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland
| | - Roman Junik
- Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland
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11
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Matar SG, El-Nahas ZS, Aladwan H, Hasanin M, Elsayed SM, Nourelden AZ, Benmelouka AY, Ragab KM. Restless Leg Syndrome in Hemodialysis Patients: A Narrative Review. Neurologist 2022; 27:194-202. [PMID: 35442939 DOI: 10.1097/nrl.0000000000000436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a clinical entity characterized by sensory-motor manifestations commonly observed in end-stage renal illness. Evidence suggests that RLS is a multifactorial phenomenon that can be influenced by many critical factors, including genetic predisposition, dietary patterns, and deficiency in some vitamins. Iron metabolism disorders and metabolic derangements have been generally accepted as predisposing elements in RLS. Furthermore, both pharmacological and neuroimaging studies demonstrated dopamine deficiency and dopamine receptors decrease in basal ganglia during RLS. REVIEW SUMMARY A literature search was done in three databases (PubMed, Google Scholar, and Cochrane) to identify the pertinent articles discussing the epidemiology, pathogenesis, and management of RLS in hemodialysis patients. RLS can affect the morbidity and mortality of patients treated with dialysis. It also has significant impacts on the quality of life since it can lead to insomnia, increased fatigue, mental health troubles, and other movement problems. Appropriate measures should be considered in this particular population so to prevent and treat RLS. Many drugs and other nonpharmacological methods have been investigated to attenuate the disease's severity. No treatment, however, could offer long-term effects. CONCLUSION Further efforts are still required to improve the understanding of RLS pathogenic trends to find more specific and efficient therapies. A wide range of treatment options is available. However, it can be individualized according to the patients' several factors.
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Affiliation(s)
- Sajeda G Matar
- Faculty of Pharmacy, University of Jordan, Amman, Jordan
- International Medical Student's Research Association (IMedRA)
| | - Zeinab S El-Nahas
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, Menoufia University, Menoufia
| | - Hala Aladwan
- Faculty of Pharmacy, University of Jordan, Amman, Jordan
- International Medical Student's Research Association (IMedRA)
| | - Menna Hasanin
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, Al-Azhar University, Cairo
| | - Sarah M Elsayed
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, October 6 University, Giza
| | - Anas Z Nourelden
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, Al-Azhar University, Cairo
| | - Amira Y Benmelouka
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, University of Algiers, Algiers, Algeria
| | - Khaled M Ragab
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, Minia University, Minia, Egypt
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12
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Liao W, Liu X, Kang N, Wang L, Zhai Z, Yang J, Wu X, Mei Y, Sang S, Wang C, Li Y. Independent and combined effects of sleep quality and night sleep duration on health-related quality of life in rural areas: a large-scale cross-sectional study. Health Qual Life Outcomes 2022; 20:31. [PMID: 35189917 PMCID: PMC8862521 DOI: 10.1186/s12955-022-01936-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The combined effect of sleep quality and night sleep duration on health-related quality of life (HRQoL) remains unclear, especially in resource-limited countries and areas. This study aimed to explore the independent and combined effects of sleep quality and night sleep duration on HRQoL. METHODS A total of 21,926 eligible participants from the Henan rural cohort study were selected. The Pittsburgh Sleep Quality Index was utilized to evaluate sleep quality and night sleep duration. The Tobit regression model, generalized linear model (GLM), and logistic regression model were performed to assess the associations of sleep quality and night sleep duration with HRQoL. The restricted cubic spline was applied to identify the dose-response relationships of sleep quality and night sleep duration with HRQoL. RESULTS After multivariable adjustment, the Tobit regression and GLM indicated that the regression coefficients [95% confidence interval (CI)] for poor sleep quality were - 0.124 (- 0.133, - 0.114) and - 6.25 (- 6.71, - 5.78) on utility index and VAS score, respectively. Compared with the reference group (7 h-), participants with short sleep duration (< 6 h) or long sleep duration (≥10 h) reported a lower HRQoL. A U-shape relationship between night sleep duration and HRQoL was observed, along with a J-shape relationship between sleep quality and HRQoL (P for non-linear < 0.001). Furthermore, individuals with longer night sleep duration (≥10 h) and poorer sleep quality were strongly associated with lower HRQoL (utility index [odds ratio (OR) (95% CI)]: 6.626 (3.548, 8.920), VAS score [OR (95% CI)]: 2.962 (1.916, 4.578)). CONCLUSION Poor sleep quality and extreme night sleep duration were independently and combinedly associated with low HRQoL, suggesting that maintaining good sleep quality and appropriate night sleep duration was important. CLINICAL TRIAL REGISTRATION The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375 .
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Affiliation(s)
- Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Ning Kang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Lulu Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Zhihan Zhai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Jing Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Xueyan Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Yongxia Mei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Shengxiang Sang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Yuqian Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China. .,Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
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13
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Guo Y, Sang Y, Pu T, Li X, Wang Y, Yu L, Liang Y, Wang L, Liu P, Tang L. Relation of Serum Hepcidin Levels and Restless Legs Syndrome in Patients Undergoing Peritoneal Dialysis. Front Med (Lausanne) 2021; 8:685601. [PMID: 34966748 PMCID: PMC8711647 DOI: 10.3389/fmed.2021.685601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Restless legs syndrome is a common and severe complication in patients undergoing peritoneal dialysis (PD), which seriously affects the life quality and prognosis of patients undergoing PD. Unfortunately, there are still no effective prevention and treatment measures. Serum hepcidin was demonstrated to be related to primary restless legs syndrome (RLS), whereas there are no studies on the relationship between serum hepcidin and RLS in patients undergoing PD. We aimed to evaluate the role and function of serum hepcidin in patients undergoing PD with RLS. Methods: A total of 51 patients undergoing PD with RLS and 102 age-and gender-matched patients undergoing PD without RLS were included. We collected the clinical data including serum hepcidin of those patients undergoing PD. We scored the severity of RLS according to the International restless leg Syndrome Research Group rating scale (IRLS). We compared the clinical characteristics of the two groups and evaluated the determinant factors of RLS by Logistic regression analysis. In addition, we evaluated the diagnostic value of serum hepcidin in patients undergoing PD with RLS by receiver operating characteristic (ROC) curve. We also analyzed the influencing factors of IRLS by multivariate linear regression analysis. Results: The duration of PD, serum hepcidin, and calcium were found to be significantly higher in patients undergoing PD with RLS than those patients undergoing PD without RLS (P < 0.001, P < 0.001, and P = 0.002, respectively). The level of hemoglobin, albumin, and RKF were significantly lower in patients undergoing PD with RLS (P = 0.002, P = 0.042, and P < 0.001, respectively). The duration of PD [odds ratio (OR) 1.038, 95% CI: 1.017, 1.060, P < 0.001], hemoglobulin level (OR 0.969, 95% CI: 0.944, 0.995, P = 0.019), calcium level (OR 9.224, 95% CI: 1.261, 67.450, P = 0.029), albumin level (OR 0.835, 95% CI: 0.757, 0.921, P < 0.001), hepcidin level (OR 1.023, 95% CI: 1.009, 1.038, P = 0.001), and RKF (OR 0.65, 95% CI: 0.495, 0.856, P = 0.002) are independent determinant factors of RLS in patients undergoing PD. Multivariate linear regression analysis revealed that, in addition to albumin, they were also independently associated with the severity of RLS. Conclusion: A significant relation was detected between serum hepcidin level and RLS in patients undergoing PD.
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Affiliation(s)
- Yanhong Guo
- Department of Nephropathy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Sang
- Department of Nephropathy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tian Pu
- Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaodan Li
- Department of Nephropathy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yulin Wang
- Department of Nephropathy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lu Yu
- Department of Nephropathy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Liang
- Department of Nephropathy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liuwei Wang
- Department of Nephropathy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Peipei Liu
- Clinical Systems Biology Laboratories, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lin Tang
- Department of Nephropathy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Abstract
Inflammation and lipid signaling are involved in the pathogenesis and progression of coronary artery disease (CAD). We proposed that high-sensitivity C-reactive proteins, as a marker of the pro-inflammatory state, and high-density lipoprotein cholesterol (HDL-C), as an anti-atherosclerosis component, should be integrated into a single novel biomarker. Our work was conducted to discuss and compare the predictive ability of the high-sensitivity C-reactive protein to high-density lipoprotein cholesterol ratio (CHR) with other existing indices, for example, neutrophil high-density lipoprotein ratio (NHR) and neutrophil lymphocyte ratio (NLR), in the severity of CAD patients.Based on the results of coronary angiography, patients were divided into the CAD+ group, CAD- group, and control group. The relationship between various serum markers and the severity of coronary artery disease was examined via Spearman's correlation analysis. Logistic regression analysis was conducted to identify the influencing factors of the coronary artery disease severity.This study included 420 patients. The Gensini score was positively correlated with CHR. Multiple regression analysis revealed that the CHR was significantly associated with CAD. CHR is an independent predictor of CAD. The receiver operating characteristic (ROC) analysis provided a cut-off value of 1.17 for CHR to predict CAD, with a specificity of 86.7%, Yoden index of 0.264, and area under the ROC curve of 0.662 (95% confidence intervals 0.606-0.719, P < 0.001). At the same time, the area under the ROC curve of the NHR was 0.652, and that of the NLR was 0.579. The results of the DeLong test indicated that the area under the ROC curve of the CHR was larger than that of the NLR (P = 0.0306). This suggests that the CHR as a predictor of CAD has better diagnostic performance than the NLR.CHR was not only closely related to the presence and severity of CAD but also an independent predictor of severe CAD.
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Affiliation(s)
- Haorou Luo
- School of Medicine, University of Electronic Science and Technology of China
| | - Tuli Kou
- School of Medicine, Southwest Medical University
| | - Lixue Yin
- Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital
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15
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Xu Y, Wen H, Li J, Yang J, Luo K, Chang L. The relationship between sleep disorders, anxiety, depression, and cognitive function with restless legs syndrome (RLS) in the elderly. Sleep Breath 2021; 26:1309-1318. [PMID: 34436711 DOI: 10.1007/s11325-021-02477-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/01/2021] [Accepted: 08/11/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Restless legs syndrome (RLS) has a significant effect on sleep and quality of life. Delays in diagnosis and treatment are frequent due to a lack of awareness. In this study, a clinical analysis was performed to examine the relationship between sleep, mood, and cognitive function in RLS. METHODS According to the Pittsburgh Sleep Quality Index score (PSQI), patients with RLS were divided into a sleep disorders group (SD, PSQI > 7) and non-sleep disorders group (NSD, PSQI ≤ 7). Healthy controls were selected as a control group matched for age, cultural background, and marital status. We compared differences between the three groups using the Hamilton Anxiety Scale (HAMA), Hamilton Depression (HAMD), Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA). The SD and NSD groups were also assessed with the Restless Leg Syndrome Rating Scale (RLSRS) and the severity of RLS between the two groups was compared. The analysis used t-test, ANOVA, and Pearson correlation. RESULTS (1) Among the 54 RLS patients, 30 people in the control group, 35 patients with sleep disorders (SD, 65%), and 19 patients without sleep disorders (NSD, 35%), there were no significant differences in age, educational level, marital status, or trauma history. (2) The comparison results of the case group (SD and NSD) and the control group showed highly significant differences (P < 0.01) in the PSQI-HAMA-HAMD score but no significant differences between the NSD group, the SD group, and the control group in MMSE score. There was no difference between the NSD group and the control group in the MoCA, but a significant difference (P < 0.05) between the SD group and the control group was found. (3) The comparison between the NSD and the SD groups revealed significant differences in the RLSRS, HAMA, and HAMD scores (P < 0.05), but there were no statistical differences (P > 0.05) between two groups on MMSE and MoCA score. (4) Correlation and regression showed that there was a linear correlation between PSQI scores and RLSRS and HAMD scores in patients with RLS (P < 0.05). The regression equation was PSQI = - 2.393 + 0.494 RLSRS + 0.170 HAMD. CONCLUSIONS RLS patients were prone to sleep disorders, anxiety, and depression. Sleep disorders increased with the severity of the RLS and had some influence on the patient's cognitive function. Sleep disorders were closely related to RLSRS and HAMD.
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Affiliation(s)
- Yuan Xu
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China.,Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| | - Hongbin Wen
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China.,Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| | - Jie Li
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China.,Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| | - Jing Yang
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| | - Kai Luo
- School of Food Science and Technology & School of Chemical Engineering, Hubei University of Arts and Science, Xiangyang, 441053, People's Republic of China.
| | - Liying Chang
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China.,Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
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16
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Safarpour Y, Vaziri ND, Jabbari B. Movement Disorders in Chronic Kidney Disease - A Descriptive Review. J Stroke Cerebrovasc Dis 2020; 30:105408. [PMID: 33139171 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105408] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/19/2020] [Accepted: 10/12/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES The objective of this study is to describe the mechanism of damage to subcortical structures in chronic kidney disease (CKD) and to describe the range of movement disorders associated with CKD. MATERIALS AND METHODS We have reviewed the Medline literature up to January of 2020 using key words movement disorders and chronic kidney disease. The reviewed articles were studied for mechanisms of subcortical damage in CKD as well as type of the reported movements, their frequency and updated treatment. RESULTS The search revealed 183 articles most of them dealing with restless legs syndrome. The damage to basal ganglia in CKD resulted from several mechanisms including accumulation of nitro tyrosine caused by reactive oxygen species and action of uremic toxins leading to endothelial damage and dysfunction of blood-brain barrier. Involuntary movements in CKD include restless legs syndrome (RLS), myoclonus, asterixis, dystonia, chorea, tremor, and Parkinsonism. CONCLUSIONS Chronic kidney disease can cause several abnormal involuntary movements via damaging basal ganglia and subcortical structures. The most common movement disorders in CKD are RLS, myoclonus and asterixis. Restless legs syndrome and myoclonus when severe, need and respond to treatment. Movement disorders in CKD improve with improvement of kidney function.
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Affiliation(s)
- Yasaman Safarpour
- Department of Medicine. University of California Riverside, School of Medicine, United States.
| | - Nosratola D Vaziri
- Division of Nephrology, Department of Medicine, University of California Irvine, United States.
| | - Bahman Jabbari
- Division of Movement Disorders, Department of Neurology, Yale University School of Medicine, United States.
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