Relationships Between Malnutrition, Inflammation, Sleep Quality, and Restless Legs Syndrome in Hemodialysis Patients

Restless legs syndrome (RLS) is a common neurologic sensorimotor disorder. It is also seen in hemodialysis patients in whom the mechanism is not thoroughly understood. The aim of this study was to evaluate the association between malnutrition-inflammation score (MIS), sleep quality, and RLS in chronic hemodialysis patients. This cross-sectional study included 232 adult stable chronic hemodialysis patients (mean age 60.9 +/- 14.1 years, 56.5% male). RLS frequency, MIS, Pittsburgh Sleep Quality Index (PSQI), laboratory data of patients as well as severity of RLS were evaluated. Thirty-seven patients (15.9%) were diagnosed with RLS. Mean MIS of patients with or without RLS were similar. PSQI of patients with RLS was significantly higher than patients without RLS (P=0.002). There was a significant positive correlation between RLS severity and PSQI (r=0.445, P=0.006). A significant positive correlation was also found between PSQI and MIS in patients with RLS (r=0.419, P=0.010). RLS severity was positively correlated with some inflammatory parameters such as white blood cell count and C-reactive protein (r=0.427, P=0.008 and r=0.418 P=0.010). PSQI was found as an independent significant predictor of RLS (odds ratio [OR]=1.15 (1.06-1.25), P=0.001) in multivariate logistic regression analysis. Our study revealed that there was no significant relationship between RLS and MIS in chronic hemodialysis patients. However, RLS severity is correlated with inflammatory parameters. Also, sleep quality in chronic hemodialysis patients with RLS is negatively associated with MIS