md-medicaldata

Authors

 

Vekoslav Mitrović¹, Radojica V. Stolić², Vladimir Mitrović<sup>3

1</sup>University of East Sarajevo, Faculty of Medicine Foca, Department of Neurology, Republic of Srpska (Bosnia and Herzegovina)
²University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Serbia
³University of Pristina Settled in Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia

 

UDK: 616.61-008.6-085.065
616.8-009.12

The paper was received / Rad primljen: 10.09.2024

Accepted / Rad prihvaćen: 10.10.2024.

 

Correspondence to:

Radojica V. Stolić
Svetozara Markovica 69
Kragujevac-34000, Serbia
e-mail: radojicastolic61@gmail.com

 

 

Abstract

 

 

Patients with restless legs syndrome experience an overwhelming urge to move their legs that is greater during inactivity and at night, and may be idiopathic or secondary. The diagnosis of restless legs syndrome is based on the diagnostic criteria established by the International Group for the Study of Restless Legs Syndrome.
Although the pathophysiology of restless legs syndrome is still partially understood, the most accepted pathophysiological mechanisms include genetic variants, abnormal iron metabolism, dopaminergic dysfunction, and the central opiate system.
In patients with chronic renal failure, restless legs syndrome is presented as one of the most significant forms of the secondary type, with a frequency of 6.6% to 80%. To prevent restless legs syndrome, it is recommended to reduce the use of provocative agents such as tricyclic antidepressants, selective serotonin reuptake inhibitors, dopamine antagonists, correction of anemia, and use of levodopa or dopamine. The symptoms of restless legs syndrome disappear after kidney transplantation, which is a confirmation that terminal renal insufficiency has a decisive role in the etiology of secondary restless legs syndrome.Even though restless legs syndrome is difficult to recognize in hemodialysis patients, this phenomenon is widespread but rarely thought about. Pathogenesis is complex and insufficiently clear, current theories suggest that dopamine and iron play an important role in subcortical neurons. This leads us to the necessary therapy with erythropoietin replacement and the use of dopaminergic agents, and the most successful form of treatment is kidney transplantation.

 

Keywords:

Restless legs syndrome; end-stage kidney disease; hemodialysis

 

 

 

Sažetak

 

 

Pacijenti sa sindromom nemirnih nogu doživljavaju ogromnu potrebu za pomeranjem nogu koja je veća tokom neaktivnosti i noću, može biti idiopatska ili sekundarna. Dijagnoza sindroma nemirnih nogu zasniva se na dijagnostičkim kriterijumima koje je ustanovila Međunarodna grupa za proučavanje sindroma nemirnih nogu. Iako je patofiziologija sindroma nemirnih nogu još uvek delimično shvaćena, najprihvaćeniji patofiziološki mehanizmi uključuju genetske varijante, abnormalni metabolizam gvožđa, dopaminergičku disfunkciju i centralni opijatni sistem. Kod pacijenata sa hroničnom bubrežnom insuficijencijom, sindrom nemirnih nogu je predstavljen kao jedan od najznačajnijih oblika sekundarnog tipa, sa učestalošću od 6,6% do 80%. Kao vid prevencije sindroma nemirnih nogu, preporučuje se smanjenje upotrebe provokativnih agenasa kao što su triciklični antidepresivi, selektivni inhibitori preuzimanja serotonina, antagonisti dopamina, korekcija anemije i upotreba levodopa ili dopamina. Simptomi sindroma nemirnih nogu nestaju nakon transplantacije bubrega, što je potvrda da terminalna bubrežna insuficijencija ima odlučujuću ulogu u etiologiji sekundarnog sindroma nemirnih nogu.
Iako je sindrom nemirnih nogu teško prepoznati kod pacijenata na hemodijalizi, ova pojava je vrlo česta, ali se o njoj retko razmišlja. Patogeneza je složena i nedovoljno jasna, sadašnje teorije sugerišu da dopamin i gvožđe igraju važnu ulogu u subkortikalnim neuronima. To nas dovodi do neophodne terapije zamenom eritropoetina i upotrebom dopaminergičkih sredstava a najuspešniji oblik lečenja predstavlja transplantacija bubrega.

 

Ključne reči:

Sindrom nemirnih nogu; terminalna bubrežna bolest; hemodijaliza

 

 

 

 

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