Restless Legs Syndrome and Quality of Life in Chronic Hemodialysis Patients

Context: Restless legs syndrome (RLS) is a sensorimotor disorder that often has a profound impact on sleep and one of the most troublesome conditions experienced in hemodialysis patients. Aims: The aim of study was to search frequency of RLS and effects of RLS on quality of life (QoL) in chronic hemodialysis patients. Settings and Design: Chronic hemodialysis patients of classical hemodialysis units were chosen. Length of the study was approximately 1 year. Subjects and Methods: Two hundred and thirty‑seven patients were investigated. RLS was diagnosed using to international the RLS questionnaire. The International RLS (IRLS) rating scale was used to calculate RLS severity. QoL was assessed using the World Health Organization QoL brief version (WHOQOL‑BREF) instrument. Statistical Analysis Used: Student’s t‑test, Chi‑square test or Fisher’s exact test, Bonferroni correction for multiple comparisons, and Pearson or Spearman correlation analysis were used. Significance level was P < 0.05. Results: The overall prevalence of RLS according to the four essential criteria was 18.6% (n = 44). According to IRLS, 22.7% of the patients with RLS were mild (n = 10), 63.6% were moderate (n = 28), and 13.7% were severe (n = 6). The parameters of QoL were compared in RLS‑positive and negative patients. There was no significant difference in psychological health (P = 0.971), social relationships (P = 0.462), and environment (P = 0.483) between two groups. Only the physical health scores were higher in without RLS than patients with RLS (P = 0.027). Conclusions: This study revealed that the frequency of RLS among chronic hemodialysis patients is 18.6% and RLS leads to physical life quality disturbances.Keywords: Hemodialysis, quality of life, restless legs syndrom

Glucose Pump Test can be Used to Measure Blood Flow Rate of Native Arteriovenous Fistula in Chronic Hemodialysis

Purpose: In chronic hemodialysis patients, the low flow of vascular access may leads to inadequate dialysis, increased rate of hospitalization, morbidity, and mortality. It was found that surveillance should be performed for native arteriovenous (AV) should not be performed for AV graft in various studies. However, surveillance was done in graft AV fistulas in most studies. Doppler ultrasonography (US) was suggested for surveillance of AV fistulas by the last vascular access guideline of National Kidney Foundation Disease Outcomes Quality Initiative (NKF KDOQI). The aim of study is to determine whether glucose pump test (GPT) is used for surveillance of native AV fistulas by using Doppler US as reference. Methods: In 93 chronic hemodialysis patients with native AV fistula, blood flow rates were measured by Doppler US and GPT. For GPT, glucose was infused to 16 mL/min by pump and was measured at basal before the infusion and 11 s after the start of the infusion by glucometer. Doppler US was done by an expert radiologist. Used statistical tests were Mann-Whitney U test, Friedman test, regression analysis, and multiple regression analysis. Results: Median values of blood flow rates measured by GPT (707 mL/min) and by Doppler US (700 mL/min) were not different (Z = 0.414, P = 0.678). Results of GPT and Doppler US measurements were positive correlate by regression analysis. The mean GPT value of diabetic patients (n = 39; 908 mL/min) was similar to that of nondiabetic patients (n = 54; 751 mL/min; Z = 1.31, P = 0.188). GPT values measured at three different dialysis session did not differ from each other that by Friedman test (F = 0.92, P = 0.39). This showed that GPT was stable and reliable. Conclusions: Glucose pump test can be used to measure blood flow rate of native AV fistula. GPT is an accurate and reliable test.Keywords: Glucose pump test, Native arteriovenous fistula, Hemodialysis, Blood flow rat