End-stage renal disease patients with restless legs syndrome related with hepcidin

Abstract

Background: Restless legs syndrome (RLS) is a neurological disorder characterized by an unpleasant sensation mainly affect the lower limbs that results in an urge to move them that occurs at rest in the evening or at night. RLS can be divided into idiopathic and symptomatic forms.

Objective: End-Stage Renal Disease prevalence of RLS ranging from 6.6 to 83% has been reported in hemodialysis (HD) patients. Desipite the mechanisms underlying the higher prevalence of RLS in the HD patients remains uncertain, some studies have suggested a priority role of iron deficiency. Hepcidin is a peptide that regulates iron status and could serve as an indicator of iron deficiency in patients with ESRD.

Patients and Methods/Material and Methods: Seventy-two stable patients on maintenance hemodialysis were enrolled (32 men, 40 women; mean age: 65.3 ± 11.6 years; mean duration of dialysis: 41.5 ± 36.5 months). Diagnosis of RLS was based on the criteria proposed by the International Restless Legs Syndrome Study Group (IRLSSG), and RLS severity was assessed using the IRLSSG Severity Scale. Potential factors associated with RLS and IRLSSG Severity Scale score were assessed by multivariate regression analyses.

Results: The RLS subgroup had significantly higher serum levels of ferritin, hepcidin, hemoglobine A1C. Serum hepcidin, hemoglobine A1C was an independent risk factor for high IRLSSG Severity Scale score.

Conclusion: This is the first study to evaluate relation between hepcidin and RLS in HD patients. This study confirms hepcidin accoding to ferritin more usable marker in HD patients. Further studies are required the pathophysiological mechanisms in dialysis patients with RLS.