The research of vascular patologies, heart rate variability, and oxidative stress markers in nondiabetic chronic hemodialysis patients with restless leg syndrome

SUMMARY?THE RESEARCH OF VASCULAR PATOLOGIES, HEARTRATE VARIABILITY, AND OXIDATIVE STRESS MARKERSIN NONDIABETIC CHRONIC HEMODIALYSIS PATIENTSWITH RESTLESS LEG SYNDROME?OBJECTIVE: Restless leg syndrome (RLS) is a situation characterized by sleepdisorders associated with sense of discomfort, pain, cramp and unvoluntary legmovements which especially occur at night in uremic patients taking hemodialysistherapy. This syndrome affects 6.6% to 62% of patients on long-term dialysistherapy and is associated with a greater mortality risk. The aims of our study areinvestigation of relationship between vascular pathologies, heart rate variabilityand oxidative stress parameters in nondiabetic chronic hemodialysis patients withRLS and evaluation of lower extremity vascular pathologies, heart rate variabilityand oxidative stress parameters in nondiabetic hemodialysis patients both withand without RLS.MATERIAL AND METHOD: Twenty five patients with end stage renal diseaseon regular hemodialysis programme who fulfilled the criteria for RLS determinedby International Restless Legs Syndrome Study Group were enrolled in the study.Twenty five nondiabetic patients with end stage renal disease on regularhemodialysis programme without restless leg syndrome were included in thecontrol group. The routine biochemical laboratory tests, complete blood counts,Kt/V, malondialdehyde and SH- groups as oxidative stress markers, lowerextremity Doppler ultrasonography and 24-hour HRV analysis were performed.RESULTS: The difference between serum creatinine, parathormone, calcium,phosphor, potassium, ferritin, mean hemodialysis duration and Kt/V of thepatients with restless leg syndrome and the control group without restless legsyndrome was not significant. In the patients with restless leg syndrome,hemoglobin and sodium levels were lower than the control group. There were nodifferences in oxidative and nonoxidative parameters. The tibialis anterior arteryblood flow and the tibialis posterior artery blood flow rates were found to belower in the restless leg syndrome group than the control group. There were nodifferences in the heart rate variability parameters, SDNNI and TI. The relationbetween existence of restless leg syndrome and the other parameters was alsoinvestigated. The relationships between restless leg syndrome and lowhemoglobin and low sodium levels, low tibialis anterior and posterior artery bloodflow rates were siginificant. Through all these factors, only the hemoglobin levelwhich is under the median was an independent factor on existence of restless legsyndrome.CONCLUSION: In conclusion, the hemoglobin level is thought to be anindependent factor for development of restless leg syndrome. Because of this, wethought that the hemoglobin levels should be normalized in the patients withrestless leg syndrome. Additionally, further investigations are required forevaluation of the other influential factors and development of treatment modalitiesin restless leg syndrome.