Abstract: TH-PO248
Arterial Pulse Enhancement Technology (A-PET) Therapy Using VascuPump for Relief of Symptoms in Restless Legs Syndrome (RLS) in Patients on Dialysis
Session Information
- Hemodialysis and Frequent Dialysis - II
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Bhalla, Anil, Sir Ganga Ram Hospital , New Delhi, India
- Singh, Ravi Kumar, Sir Ganga Ram Hospital , New Delhi, India
- Rana, Devinder S., Sir Ganga Ram Hospital , New Delhi, India
- Gupta, Ashwani, Sir Ganga Ram Hospital , New Delhi, India
- Gupta, Anurag, Synegy Hospital, Uttarakhand, India
- Bhargava, Vinant, Sir Ganga Ram Hospital , New Delhi, India
Background
Restless legs syndrome (RLS) occurs in 25% to 40% patients on hemodialysis. In patients on dialysis poly-pharmacy and pill burden is a significant risk factor and there is a need for treatment which is noninvasive, non-pharmacologic, time efficient and has long lasting response. Arterial Pulse Enhancement Technology (A-PET) therapy delivered using VascuPump is noninvasive, non-pharmacologic treatment given during dialysis for 15 minute on both legs (no extra visit). VascuPump device uses inflatable cuffs, placed around calf, to rhythmically compress the limb with each heartbeat to enhance blood flow down the limb.
Methods
Open labelled treatment for patients on maintenance hemodialysis thrice per week. Six treatments were given during consecutive dialysis sessions. Patients with DVT, aortic insufficiency, leg wound or ulcer, acute thrombophlebitis and medically unstable patients were excluded. Baseline Doppler study was done to exclude DVT. To assess RLS, International RLS Study Group Rating Scale (IRLSSG) was used, range 1-40. Wong Baker Pain Scale (WBPS) was used before and after treatment, range 0-10.
Results
52 patients with mean age 58.4 yr (range 26-77), male 32 (62%), diabetes 40 (77%). RLS score at start of the treatment was 27.1 (17-39) which dropped to 20 (14-34) at the end of the last treatment. WBPS before and after treatment was 7.6 (2-10) and 3.3 (2-8) respectively. The acute response after cumulative 270 treatments was a 41% decrease in pain. There was a trend towards consistent decrease in the baseline WBPS of individual patients with multiple treatments. Average Relief lasted for an average of 55 hours (range 0-172 hrs) after individual treatment. A total of 14 patients did not complete the six treatments due to unstable clinical condition or no response. One patient had worsening cramps in the legs. There were no other complications observed after 270 cumulative treatments in these patients on dialysis. A total of 73% (38/52) patients benefitted from the treatment.
Conclusion
A-PET therapy during dialysis is an effective non pharmacologic therapy for RLS patients on maintenance hemodialysis. Further randomized controlled studies are needed in larger population.