Periodic limb movements in sleep are associated with stroke and cardiovascular risk factors in patients with renal failure
ANETT LINDNER
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Department of Neurology, Semmelweis University, Budapest, Hungary
Search for more papers by this authorKATALIN FORNADI
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Department of Neurology, Semmelweis University, Budapest, Hungary
Search for more papers by this authorALPAR S. LAZAR
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Search for more papers by this authorMARIA E. CZIRA
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Search for more papers by this authorANDREA DUNAI
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Search for more papers by this authorREZSO ZOLLER
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Search for more papers by this authorORSOLYA VEBER
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Search for more papers by this authorANDRAS SZENTKIRALYI
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
Search for more papers by this authorEVA TORONYI
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
Search for more papers by this authorISTVAN MUCSI
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Department of Medicine, Division of Nephrology, McGill University Health Centre, Montreal, Quebec, Canada
Search for more papers by this authorMARTA NOVAK
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada
Search for more papers by this authorMIKLOS Z. MOLNAR
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Institute of Pathophysiology, Semmelweis University, Budapest, Hungary
Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor–UCLA Medical Center, Torrance, CA, USA
Search for more papers by this authorANETT LINDNER
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Department of Neurology, Semmelweis University, Budapest, Hungary
Search for more papers by this authorKATALIN FORNADI
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Department of Neurology, Semmelweis University, Budapest, Hungary
Search for more papers by this authorALPAR S. LAZAR
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Search for more papers by this authorMARIA E. CZIRA
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Search for more papers by this authorANDREA DUNAI
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Search for more papers by this authorREZSO ZOLLER
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Search for more papers by this authorORSOLYA VEBER
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Search for more papers by this authorANDRAS SZENTKIRALYI
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
Search for more papers by this authorEVA TORONYI
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
Search for more papers by this authorISTVAN MUCSI
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Department of Medicine, Division of Nephrology, McGill University Health Centre, Montreal, Quebec, Canada
Search for more papers by this authorMARTA NOVAK
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada
Search for more papers by this authorMIKLOS Z. MOLNAR
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
Institute of Pathophysiology, Semmelweis University, Budapest, Hungary
Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor–UCLA Medical Center, Torrance, CA, USA
Search for more papers by this authorSummary
Periodic limb movements in sleep (PLMS) is prevalent among dialysed patients and is associated with increased risk of mortality. Our study aimed to determine the prevalence of this disease in a sample of transplanted and waiting-list haemodialysed patients. One hundred transplanted and 50 waiting-list patients underwent polysomnography. Moderate and severe diseases were defined as periodic limb movements in sleep index (PLMSI) higher than 15 and 25 events h−1, respectively. The 10-year coronary heart disease risk was estimated for all patients using the Framingham Score. Moreover, the 10-year estimated risk of stroke was calculated according to the modified version of the Framingham Stroke Risk Profile. PLMS was present in 27% of the transplanted and 42% of the waiting-list group (P = 0.094); the proportion of severe disease was twice as high in waiting-list versus transplanted patients (32 versus 16%, P = 0.024). Patients with severe disease had a higher 10-year estimated risk of stroke in the transplanted group [10 (7–17) versus 5 (4–10); P = 0.002] and a higher 10-year coronary heart disease risk in both the transplanted [18 (8–22) versus 7 (4–14); P = 0.002], and the waiting-list groups [11 (5–18) versus 4 (1–9); P = 0.032]. In multivariable linear regression models the PLMSI was associated independently with the Framingham cardiovascular and cerebrovascular scores after adjusting for important covariables. Higher PLMSI is an independent predictor of higher cardiovascular and cerebrovascular risk score in patients with chronic kidney disease. Severe PLMS is less frequent in kidney transplant recipients compared to waiting-list dialysis patients.
Supporting Information
Figure S1. Flowchart of the patient selection.
Table S1. Subgroups based on estimated glomerular filtration rate (eGFR) in the transplantation (Tx) group.
Table S2. Linear regression model in the total population (dependent variable: logarithm of Framingham stroke risk).
Table S3. Linear regression model in the waitlisted hemodialysis group (dependent variable: logarithm of Framingham stroke risk).
Table S4. Linear regression model in the transplantation (Tx) group (dependent variable: logarithm of Framingham stroke risk).
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| JSR_956_sm_FigS1-TableS1-4.doc120.5 KB | Supporting info item |
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