Periodic limb movements in sleep are associated with stroke and cardiovascular risk factors in patients with renal failure

摘要

Periodic limb movements in sleep (PLMS) is prevalent among uddialysed patients and is associated with increased risk of udmortality. Our study aimed to determine the prevalence of this uddisease in a sample of transplanted and waiting-list udhaemodialysed patients. One hundred transplanted and 50 waiting-udlist patients underwent polysomnography. Moderate and severe uddiseases were defined as periodic limb movements in sleep index ud(PLMSI) higher than 15 and 25 events h(-1) , respectively. The ud10-year coronary heart disease risk was estimated for all udpatients using the Framingham Score. Moreover, the 10-year udestimated risk of stroke was calculated according to the udmodified version of the Framingham Stroke Risk Profile. PLMS udwas present in 27% of the transplanted and 42% of the waiting-udlist group (P = 0.094); the proportion of severe disease was udtwice as high in waiting-list versus transplanted patients (32 udversus 16%, P = 0.024). Patients with severe disease had a udhigher 10-year estimated risk of stroke in the transplanted udgroup [10 (7-17) versus 5 (4-10); P = 0.002] and a higher 10-udyear coronary heart disease risk in both the transplanted [18 ud(8-22) versus 7 (4-14); P = 0.002], and the waiting-list groups ud[11 (5-18) versus 4 (1-9); P = 0.032]. In multivariable linear udregression models the PLMSI was associated independently with udthe Framingham cardiovascular and cerebrovascular scores after udadjusting for important covariables. Higher PLMSI is an udindependent predictor of higher cardiovascular and udcerebrovascular risk score in patients with chronic kidney uddisease. Severe PLMS is less frequent in kidney transplant udrecipients compared to waiting-list dialysis patients.