Abstract: 【Abstract】Purpose To investigate the prevalence and risk factors for restless legs syndrome (RLS) in maintenance peritoneal dialysis (PD) patients. Methods The maintenance PD patients treated in The Second Hospital of Anhui Medical University between Mar 1, 2013 and Nov 31, 2013, regularly followed-up for over 3 months, and with the age of ≥18 to ≤75 years old were enrolled in this study. Demographic information, laboratory indicators, depression and RLS assessment data were collected. We measured the severity of RLS by using the rating scale from the International Restless Legs Syndrome Study Group (IRLSSG). For patients
continuing to use PD between Mar 1, 2015 and Nov 31, 2015, their data were collected again and the relationship between the indicators and the occurrence of RLS was re-evaluated. Results There were 71 PD cases in the study. At baseline, 31 (43.7%) were diagnosed with RLS (RLS+ group). Compare to the RLS- group, the incidence of depression and the levels of serum phosphorus and parathyroid hormone were significantly higher in the RLS+ group (χ2=9.291, P=0.002; t=-2.668, P=0.010; Z=-2.274, P= 0.023). Correlation analysis suggested depression, serum phosphorus and parathyroid hormone were positively correlated with RLS (r=0.362, P=0.002; r=0.322, P=0.006; r=0.276, P=0.022). Logistic regression analysis showed that depression and higher serum phosphorus were the risk factors for RLS at baseline (OR=5.465, 95% CI=1.712～17.439, P=0.004;OR=3.597, 95% CI=1.190～10.867, P=0.023). According to the rating scale of IRLSSG in the RLS+ group, 35.5% were mild RLS, 29.0% were moderate RLS, and 35.5% were severe or very severe RLS. Patients with severer RLS had longer dialysis duration (Z=-3.711, P＜0.001), higher body mass index (t=-2.244, P=0.038), higher sensitive C-reactive protein (Z=-2.595, P=0.009), and lower alkaline phosphatase (t=2.106, P=0.049). Of the 55 patients who completed the second assessment, 35 (63.6%) were diagnosed with RLS, similar to the incidence at baseline (χ2=2.981, P=0.108). Logistic regression model indicated that parathyroid hormone at baseline was the risk factors for RLS in the follow-up period (OR=1.003, 95% CI=1.000～1.006, P=0.027) and for persistent RLS (OR=1.005, 95% CI=1.000～1.009, P=0.030). Conclusion The prevalence of RLS in this series of maintenance PD patients was 43.7%. Patients with RLS were more likely to have depression and higher levels of serum phosphorus and parathyroid hormone. Depression,higher levels of serum phosphorus and parathyroid hormone were the risk factors for RLS..

Key words: Peritoneal dialysis, Restless legs syndrome, Parathyroid hormone