Giulio Romano, MD, professor of nephrology at the University of Udine in Italy, told Medscape Medical News that “the interesting conclusion of our work is that there is a correlation between Restless Legs Syndrome and an increase of inflammatory cytokines and the increase of CRP (inflammation biomarker).”
Dr. Romano noted that several studies have shown that increased inflammation is associated with elevated cardiovascular risk in patients on chronic hemodialysis. Also, he said there is evidence that sleep disorders induce elevated levels of proinflammatory cytokines.
“We think that if patients have some sleep disorders, they evoke inflammation,” he said; “if we treat the sleep disorders, we reduce a cardiovascular risk factor because CRP is a possible cause of increased cardiovascular risk.” The hemodialysis patients without RLS, he noted, had much lower CRP levels. Similarly, the levels of transferrin saturation, another marker of inflammation, were different between patients with and without RLS.
Nageswara Reddy, MD, assistant professor of nephrology at Manipal University in India, who was not involved with the study, told Medscape Medical News that it makes sense to him that RLS is associated with inflammatory markers. Cardiovascular mortality, which is the main cause of death among hemodialysis patients, is associated with elevated levels of CRP, but it might be associated with other underlying causes as well.
“We have to find out all risk factors. Maybe lack of sleep is another risk factor,” Dr. Reddy hypothesized, and suggested that other inflammatory markers, in addition to CRP, be investigated.
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