Meta-analysis of the prevalence of restless leg syndrome and associated risk factors in chronic kidney disease patients
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Introduction: Restless legs syndrome (RLS) presents as a sleep-related issue in individuals with chronic kidney disease (CKD), contributing to heightened sleep disturbances and diminished quality of life. Consequently, this meta-analysis was conducted to assess the prevalence of RLS among CKD patients.
Methods: A comprehensive search for articles published between inception and September 2023 was conducted across CINAHL, Cochrane, Embase, Ovid-MEDLINE, PubMed, Scopus, and Web of Science databases. A Comprehensive Meta-Analysis (CMA) software version 3.0 with random effects models was used for pooled prevalence and prediction interval analysis. Heterogeneity was assessed using the I2 test and Cochran's Q-statistic. The quality of the studies was evaluated using Hoy's risk of bias. Additionally, moderator analyses were performed to investigate variations in the prevalence estimates among the included studies.
Results: A total of 97 studies were included in this meta-analysis with 315,875 participants. The pooled prevalence of RLS among CKD patients was 25% (95%CI: 20% to 32%). In terms of the demographic breakdown, the prevalence of RLS was nearly comparable in adults and children/adolescents at 25% and 21%, respectively. The prediction interval indicated a potential future RLS prevalence ranging from 1% to 88%. Notably, iron and phosphorus levels emerged as significant moderating factors influencing the prevalence of RLS.
Conclusions: Roughly 25% of individuals with chronic kidney disease (CKD) encounter restless legs syndrome (RLS). It is imperative to foster collaboration among healthcare professionals to facilitate proactive management and early assessment of RLS, thereby enhancing the overall quality of life for CKD patients.
Ahn, E. & Kang, H. (2018). Introduction to systematic review and meta-analysis. Korean J Anesthesiol, 71.2, 103-112.doi: 10.4097/kjae.2018.71.2.103
Aini, N., et al. (2024). Association between chronic kidney disease and restless leg syndrome (RLS): A systematic review and meta-analysis. Sleep Biol Rhythms, 22.2, 227-237.doi: 10.1007/s41105-024-00513-4
Beladi-Mousavi, S. S., et al. (2015). Restless legs syndrome: Associated risk factors in hemodialysis patients. Nephro-Urology Monthly, 7.6.doi: 10.5812/numonthly.31967
Chen, J.-J., et al. (2022). Pharmacological and non-pharmacological treatments for restless legs syndrome in end-stage kidney disease: a systematic review and component network meta-analysis. Nephrology Dialysis Transplantation, 37.10, 1982-1992.doi: 10.1093/ndt/gfab290
Ghanei Gheshlagh, R., et al. (2017). The prevalence of restless legs syndrome in patients undergoing hemodialysis: A systematic review and meta-analysis study. Basic Clin Neurosci, 8.2, 105-112.doi: 10.18869/nirp.bcn.8.2.105
Giannaki, C. D., et al. (2017). Restless legs syndrome is contributing to fatigue and low quality of life levels in hemodialysis patients. World J Nephrol, 6.5, 221-242.doi: 10.5527/wjn.v6.i5.236
Higgins, J. P., et al. (2003). Measuring inconsistency in meta-analyses. Bmj, 327.7414, 557-60.doi: 10.1136/bmj.327.7414.557
Hoy, D., et al. (2012). Assessing risk of bias in prevalence studies: Modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol, 65.9, 934-9.doi: 10.1016/j.jclinepi.2011.11.014
Inthout, J., et al. (2016). Plea for routinely presenting prediction intervals in meta-analysis. BMJ Open, 6.7, e010247.doi: 10.1136/bmjopen-2015-010247
Kang, K.-T., et al. (2022). Prevalence of sleep disorders in children with chronic kidney disease: a meta-analysis. Pediatric Nephrology, 37.11, 2571-2582.doi: 10.1007/s00467-022-05536-y
Kubo, K., et al. (2016). Relationship between quality of life and restless legs syndrome among a community-dwelling population in Japan. Neuropsychiatr Dis Treat, 12. 809-15.doi: 10.2147/NDT.S102089
Lin, X. W., et al. (2019). Restless legs syndrome in end stage renal disease patients undergoing hemodialysis. BMC Neurol, 19.1, 47.doi: 10.1186/s12883-019-1265-y
Lin, Z., et al. (2016). Prevalence of restless legs syndrome in chronic kidney disease: A systematic review and meta-analysis of observational studies. Renal Failure, 38.9, 1335-1346.doi: 10.1080/0886022X.2016.1227564
Liu, Y., et al. (2024). Prevalence of restless legs syndrome in maintenance hemodialysis patients: A systematic review and meta-analysis. Sleep Med, 114. 15-23.doi: 10.1016/j.sleep.2023.11.1138
Lundorff, M., et al. (2017). Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. J Affect Disord, 212. 138-149.doi: 10.1016/j.jad.2017.01.030
Mansourian, M., et al. (2020). Are serum vitamin D, calcium and phosphorous associated with restless leg syndrome? A systematic review and meta-analysis. Sleep Med, 75. 326-334.doi: 10.1016/j.sleep.2020.08.022
Mao, S., et al. (2014). Restless legs syndrome in dialysis patients: A meta-analysis. Sleep Med, 15.12, 1532-8.doi: 10.1016/j.sleep.2014.07.017
Maung, S. C., et al. (2016). Sleep disorders and chronic kidney disease. World J Nephrol, 5.3, 224-32.doi: 10.5527/wjn.v5.i3.224
Mchugh, M. L. (2012). Interrater reliability: The kappa statistic. Biochem Med (Zagreb), 22.3, 276-82.doi:
Muzasti, R. A. & Harahap, R. H. 2019. The role of anemia to restless legs syndrome in regular hemodialysis patients in Haji Adam Malik Medan general hospital. Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease.
National Kidney Foundation. 2024. Kidney failure risk factor: Serum phosphorus [Online]. Available: https://www.kidney.org/content/kidney-failure-risk-factor-serum-phosphorus [Accessed January 14 2024].
Nigam, G., et al. (2018). Exploring sleep disorders in patients with chronic kidney disease. Nat Sci Sleep, 10. 35-43.doi: 10.2147/NSS.S125839
Novak, M., et al. (2015). Restless legs syndrome in patients with chronic kidney disease. Semin Nephrol, 35.4, 347-58.doi: 10.1016/j.semnephrol.2015.06.006
Page, M. J., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372. n71.doi: 10.1136/bmj.n71
Peters, J. L., et al. (2006). Comparison of two methods to detect publication bias in meta-analysis. JAMA, 295.6.doi:
Safarpour, Y., et al. (2023). Restless Legs Syndrome in Chronic Kidney Disease- a Systematic Review. Tremor and other hyperkinetic movements (New York, N.Y.), 13. 10.doi: https://dx.doi.org/10.5334/tohm.752
Santos, R. S., et al. (2016). Parathyroidectomy improves restless leg syndrome in patients on hemodialysis. PLoS One, 11.5, e0155835.doi: 10.1371/journal.pone.0155835
Saparfour, Y., et al. (2023). Restless legs syndrome in chronic kidney disease: A systematic review. Tremor Other Hyperkinet Mov (N Y), 13. 10.doi: 10.5334/tohm.752
Shi, Y., et al. (2015). Prevalence and risk factors of restless legs syndrome among Chinese adults in a rural community of Shanghai in China. PLoS One, 10.3, e0121215.doi: 10.1371/journal.pone.0121215
Tan, L. H., et al. (2022). Insomnia and poor sleep in CKD: A systematic review and meta-analysis. Kidney Med, 4.5, 100458.doi: 10.1016/j.xkme.2022.100458
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