Síndrome de Piernas Inquietas en enfermedad renal crónica terminal en hemodiálisis

Castillo-Torres, Sergio Andrés; Ibarra-Sifuentes, Héctor Raúl; Sánchez-Terán, Helda; Sánchez-Martínez, Concepción; Chávez-Luévanos, Beatriz; Estrada-Bellmann, Ingrid

doi:10.1590/0004-282X20180133

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Article • Arq. Neuro-Psiquiatr. 76 (12) • Dic 2018 • https://doi.org/10.1590/0004-282X20180133 copiar

Síndrome de Piernas Inquietas en enfermedad renal crónica terminal en hemodiálisis

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

El síndrome de piernas inquietas (SPI) es una complicación de la hemodiálisis que se ha asociado con menor calidad de vida y riesgo aumentado de complicaciones. Sin embargo, existen pocos estudios acerca de esta entidad en escenarios de recursos limitados.

Objetivos:

Determinar la prevalencia de SPI en pacientes mexicanos en hemodiálisis, y comparar las características con un grupo control de la misma población.

Métodos:

Reclutamos 105 pacientes en hemodiálisis. El SPI se diagnosticó de acuerdo con los criterios actualizados del grupo de estudio internacional del síndrome de piernas inquietas. Seleccionamos a los pacientes que no cumplieron dichos criterios como controles.

Resultados:

Encontramos una prevalencia de SPI del 18%. Los pacientes con SPI tenían una prevalencia más alta de anemia ferropénica, y prurito urémico. Ninguno de los pacientes reportó síntomas de SPI previo a iniciar la hemodiálisis.

Conclusiones:

El SPI es frecuente en pacientes mexicanos en hemodiálisis; se requieren estudios más grandes para evaluar el impacto del síndrome en ésta población.

Palabras-clave:
Síndrome de piernas inquietas; diálisis renal; insuficiencia renal

Variable	RLS	Controls	p-value^* * significant difference at .05 level;
Number of participants	19	86	na
Age (years).	45.5 ± 17.1	50.2 ± 16.0	0.253^a a p-value: calculated using the Chi square test;
Female sex - no. (%)	11 (57.9%)	47 (54.7%)	0.797^b b p-value: calculated using t test;
Hypertension - no. (%)	18 (97.4%)	77 (89.5%)	0.485 ^a a p-value: calculated using the Chi square test;
Diabetes mellitus - no. (%)	11 (57.9%)	48 (55.8%)	0.869 ^a a p-value: calculated using the Chi square test;
Iron-deficiency anemia - no. (%)	12 (63.2%)	32 (372%)	0.038 ^a a p-value: calculated using the Chi square test;
Peripheral neuropathy - no. (%)	2 (10.5%)	6 (7.0%)	0.598 ^a a p-value: calculated using the Chi square test;
Cerebrovascular disease - no. (%)	2 (10.5%)	4 (4.7%)	0.318 ^a a p-value: calculated using the Chi square test;
Duration of end-stage renal disease (years)	2.5 (0.04-9.0)	2.0 (0.2 – 25.0)	0.980^c c p-value: calculated using the Mann-Whitney U test.
Duration of undergoing hemodialysis (years)	2.0 (0.04-7.0)	1.65 (0.04 – 13.0)	0.851 ^c c p-value: calculated using the Mann-Whitney U test.
Number of hemodialysis sessions per week - no. (%)	2.0 (1.0-3.0)	2.0 (1.0 – 4.0)	0.541 ^c c p-value: calculated using the Mann-Whitney U test.
Total number of hemodialysis sessions - no.	129 (5-397)	93 (7 – 483)	0.573 ^c c p-value: calculated using the Mann-Whitney U test.
Type of access: intravenous catheter. - no. (%)	19 (100%)	76 (91.6%)	0.167 ^a a p-value: calculated using the Chi square test;
Uremic pruritus - no. (%)	8 (42.1%)	17 (20.5%)	0.039 ^a a p-value: calculated using the Chi square test;

Variable	RLS	Controls	p-value^* * Significant difference at .05 level; RLS: restless legs syndrome; eGFR-MDRD4: estimated glomerular filtration rate calculated with MDRD 4 element formula;
Number of participants	19	86	na
Hemoglobin (g/dL)	7.91 ± 1.38	8.79 ± 1.89	0.064^a a p-value: calculated using t test;
Hematocrit (%)	24.8 ± 4.3	27.7 ± 5.9	0.055^a a p-value: calculated using t test;
Mean corpuscular volume (fL)	90.3 ± 7.4	91.3 ± 6.0	0.537^a a p-value: calculated using t test;
Mean hemoglobin concentration (pg)	28.9 ± 2.8	28.9 ± 2.1	0.999^a a p-value: calculated using t test;
Platelet count (cell/mm³)	189,837 ± 68,866	193,764 ± 75,257	0.819^b b p-value: calculated using the Mann-Whitney U test.
Mean platelet volume (fL)	7.12 ± 1.38	6.80 ± 1.40	0.341^b b p-value: calculated using the Mann-Whitney U test.
Blood urea nitrogen (mg/dL)	53.6 ± 27.3	61.5 ± 26.8	0.246^a a p-value: calculated using t test;
Serum creatinine (mg/dL)	9.7 ± 3.6	9.0 ± 3.7	0.462^a a p-value: calculated using t test;
eGFR-MDRD-4 (mL/min/1.73m2)	7.3 ± 3.2	8.3 ± 6.8	0.821^b b p-value: calculated using the Mann-Whitney U test.
Sodium (mmol/L)	137.1 ± 2.9	137.3 ± 4.0	0.848^a a p-value: calculated using t test;
Potassium (mmol/L)	5.0 ± 0.9	5.3 ± 1.0	0.398^b b p-value: calculated using the Mann-Whitney U test.
Chloride (mmol/L)	101.9 ± 4.8	101.7 ± 4.6	0.886^a a p-value: calculated using t test;
Magnesium (mg/dL)	2.7 ± 0.4	2.8 ± 0.6	0.288^b b p-value: calculated using the Mann-Whitney U test.
Phosphorus (mg/dL)	5.1 ± 1.5	5.1 ± 1.7	0.987^a a p-value: calculated using t test;
Calcium (mg/dL)	8.2 ± 0.9	8.4 ± 1.1	0.699^b b p-value: calculated using the Mann-Whitney U test.

Variable	Beta	SE	p-value	OR	95%CI
Iron deficiency anemia	-0.950	0.545	0.082	0.4	(0.1-1.1)
Duration of undergoing hemodialysis (years)	-0.044	0.145	0.759	1.0	(0.7-1.3)
Uremic pruritus	-0.915	0.555	0.099	0.4	(0.1-1.2)
Hemoglobin	-0.304	0.183	0.096	0.7	(0.5-1.1)

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[1] Correspondence: Sergio Andrés Castillo-Torres; Servicio de Neurología, Hospital Universitario “Dr. José E. González” Universidad Autónoma de Nuevo León; Madero y Gonzalitos S/N, Col. Mitras Centro, Monterrey, NL, México. CP 64460. Telephone: +5218183471059. E-mail: sergio.castillotr@uanl.edu.mx