Abstract: TH-PO927

Restless Legs Syndrome (RLS): An Unresolved Uremic Disorder after Successful Renal Transplantation (TXR)

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Cigarran, Secundino, Eoxi Cervo-Lugo-Monforte, Burela, Lugo, Spain
  • Latorre, Juan, Eoxi Cervo-Lugo-Monforte, Burela, Lugo, Spain
  • Sobrido, maria-jesus, IDIS. Sergas, Santiago Compostela, Spain
  • Calvino, Jesus, Eoxi Cervo-Lugo-Monforte, Lugo, Spain
  • Gonzalez tabares, Lourdes, Eoxi Cervo-Lugo-Monforte, Lugo, Spain
  • Guijarro, Monica, Eoxi Cervo-Lugo-Monforte, Lugo, Spain
  • Menendez, Nicolas, Eoxi Cervo-Lugo-Monforte, Burela, Lugo, Spain
  • Cobelo casas, Carmen Raquel, Eoxi Cervo-Lugo-Monforte, Lugo, Spain
  • Millan, Beatriz, Eoxi Cervo-Lugo-Monforte, Lugo, Spain
  • Sanjurjo amado, Ana maria, Eoxi Cervo-Lugo-Monforte, Burela, Lugo, Spain
  • Cillero, Sonia, Eoxi Cervo-Lugo-Monforte, Lugo, Spain
Background

RLS is a common disorder of uremia that may improve after TXR. However, RLS frequency might not be as low as expected as some uremic disturbances related with RLS may continue even after a successful graft.
The aim of this study was to assess the prevalence and related conditions for RLS in TXR.

Methods

A validated questionnaire fof RLS study group diagnostic criteria was self-administered by 129 TXR, 82 men and 47 women, aged 57 ± 12.8 years followed in the nephrology clinic for more than one year and with stable renal function (creatinine 1.5 ± 0.54 mg/dL). Patients classified as probable RLS according to the questionnaire underwent a systematic neurological examination in order to exclude RLS mimics.

Results

The frequency of probable RLS according to the questionnaire results was 29.5% (18 men and 20 women). After thorough neurological examination, the diagnosis of RLS was confirmed in 18 patients providing an overall definitive RLS frequency of 14.5% (above the average prevalence reported for the general population). Therefore, RLS diagnosis was established for six men (7.5%) and 12 women (27. 3%). These results rendered a positive predictive value for the self-administered questionnaire remarkably higher for women (60%) than for men (33%) pinpointing a higher rate of RLS mimics among men. Besides gender differences, confirmed RLS cases showed no differences regarding age, diabetes, comorbid disorders, BMI, anticalcineurin therapy, renal function, anemia and time from transplantation. Neither blood pressure nor number of antihypertensive drugs was statistically different though RAAS blockade was significantly less frequent among the confirmed RLS cases (22.2% versus 47.2%). Because of the clear-cut preponderance of women, we performed a separate analysis for females. A poorer renal function estimated by CKD-EPI (52 ± 17.5 vs 42 ± 13.9 ml/min) and a lower phosphate tubular reabsorption rate (75 ± 10.5 vs 65 ± 9.2) characterized women with RLS.

Conclusion

RLS prevalence after transplantation (14.5%) remains high. This condition is twice more prevalent for females. Contribution of RAAS, graft function impairment and phosphate overload for this remarkable prevalence requires further investigation.

Funding

  • Other NIH Support