Nefrología (English Edition) (Jan 2018)

Effects of rotigotine on clinical symptoms, quality of life and sleep hygiene adequacy in hemodialysis-associated restless legs syndrome

  • Vicent Esteve,
  • Jose Carneiro,
  • Gabriel Salazar,
  • Mónica Pou,
  • Irati Tapia,
  • Miquel Fulquet,
  • Verónica Duarte,
  • Anna Saurina,
  • Fátima Moreno,
  • Manel Ramírez de Arellano

DOI
https://doi.org/10.1016/j.nefroe.2017.11.017
Journal volume & issue
Vol. 38, no. 1
pp. 79 – 86

Abstract

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Background: Restless legs syndrome (RLS) is a neurological disorder characterized by bothersome symptoms associated with impaired quality of life and sleep hygiene. Rotigotine is a novel therapeutic alternative, although few studies have been published in patients on hemodialysis (HD) with RLS treated with rotigotine. Objectives: (1) To establish the prevalence of RLS in our HD unit. (2) To evaluate the efficacy and safety profile of rotigotine and its effect on symptoms, quality of life and sleep hygiene in our HD population with RLS. Material and methods: A single-center, 12-week prospective study. Two stages (6 weeks): stage 1 (no treatment) and stage 2 (rotigotine). We analyzed: (1) Demographic data, biochemistry data, HD suitability parameters and RLS medical treatment data. (2) Lower extremity symptoms questionnaire (QS). (3) RLS severity symptoms scale (SRLSS). (4) RLS quality of life: John Hopkins RLS-QoL (JH-QoL). (5) Sleep hygiene: SCOPA Scale. Results: We included 66 HD patients, 14 with RLS; 44.4% male, 70.2 ± 9.9 years and 111.1 ± 160.8 months on HD and 22.9% RLS. Exclusively in stage 2, a significant improvement for QS (10 ± 2.4 vs. 5.7 ± 1.0), SRLSS (21 ± 4 vs. 5.7 ± 4.6), JH-QoL (22.1 ± 4.4 vs. 4.3 ± 4.0) and SCOPA (16 ± 5.3 vs. 6.7 ± 1.9) were observed. A 77.7 and 11.1%, showed partial (>20%) and complete (>80%) remission, respectively, while 55.5% achieved “zero” symptoms. Only one patient had gastrointestinal intolerance and none experienced augmentation effect. No changes in biochemical data, suitability for dialysis or medical treatment were found. The inter-group analysis showed a significant improvement in relation to QS, SRLSS, JH-QoL and SCOPA in stage 2. Conclusions: RLS showed a considerable prevalence in our HD unit. Rotigotine improved clinical symptoms, quality of life and sleep hygiene in RLS patients on HD and was found to be a safe drug with minimal side effects and total therapeutic compliance. Nevertheless, future studies should be performed to confirm the benefits of rotigotine in RLS patients on hemodialysis.

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