Copyright
©The Author(s) 2018.
World J Hepatol. Mar 27, 2018; 10(3): 379-387
Published online Mar 27, 2018. doi: 10.4254/wjh.v10.i3.379
Published online Mar 27, 2018. doi: 10.4254/wjh.v10.i3.379
Table 1 Baseline general conditions of patients recruited
Characteristic | Hepatic failure, n = 211 |
Male/female | 107/104 |
Age in year, mean and standard deviation | 59 ± 4.7 |
(median range) | (36-74) |
BMI, kg/m2 | 25.43 ± 4.1 |
Cause of liver disease, n | 211 |
Previous alcohol abuse | 139 |
Hepatic venous outflow tract obstruction | 14 |
Cryptogenic | 12 |
Liver primary tumor | 46 |
Child-Pugh class; number | 211 |
A | 132 |
B | 54 |
C | 25 |
Table 2 Baseline metabolic parameters of 211 patients recruited
Labs parameter (normal values) | Average of 211 patients (range) |
Hemoglobin (14-16 g/dL) | 11.1 (7.5-12.3) |
Platelets counts (150-400 × 1000/μL) | 97 (65-423) |
Serum protein (g/dL) | 7.6 (3.4-10.1) |
Serum bilirubin (0.1-1.3 mg/dL) | 1.7 (0.9-12) |
Alanine aminotransferase (8-55 IU/L) | 77 (24-452) |
Aspartate aminotransferase (8-48 IU/L) | 71 (34-715) |
International normalized ratio (INR) | 1.8 (1.0-4.9) |
Serum creatinine (0.6-1.2 mg/dL) | 1.0 (0.6-2.1) |
Serum albumin (3.7-5.0 g/dL) | 3.5 (1.5-5.1) |
Ammonium (40-80 μg/dL) | 97 (45-134) |
Folate (3.89-26.0 ng/mL) | 2.3 (1.9-12.3) |
Iron free level (40-150 μg/dL) | 26.5 (12-89) |
Ferritine (20-200 ng/mL) | 235 (126-456) |
Vitamin B12 ( 205-870 pg/mL) | 189 (121-245) |
Vitamin D-OH25 (30-100 ng/mL) | 41 (12-130) |
Table 3 Synopsis of the tests at baseline
Test (range) | Results |
Hamilton rating scale (0-66) | 18.5 ± 4.5 |
PSQI (0-5) | 3.4 ± 0.5 |
ESS (0-24) | 11 ± 2.1 |
IRLSSG | Fulfillment of criteria: |
211/211 | |
IRSL (0-40) | 0-10 (mild) = 22 |
11-20 (moderate) = 76 | |
21-30 (severe) = 109 | |
31-40 (very severe) = 4 |
Table 4 Synopsis of pramipexole titration
Patients | Baseline | 75th day | 105th d | 135th day | 165th day | 205th day |
211 | 0.18 mg | |||||
211 | 0.7 mg | |||||
211 | 0.88 mg | |||||
170 | 1.4 mg | |||||
134 | 1.4 mg | |||||
36 | 0.88 mg | |||||
110 | 1.4 mg | |||||
60 | 0.7 mg |
Table 5 Synopsis of gabapentin titration
Patients | 45th day | 75th day | 105th day | 135th day | 165th day | 205th day |
41 | 100 mg | |||||
41 | 300 mg | |||||
35 | 300 mg | |||||
6 | 400 mg | |||||
30 | 300 mg | |||||
11 | 500 mg | |||||
27 | 300 mg | |||||
14 | 600 mg | |||||
16 | 300 mg | |||||
25 | 600 mg |
Table 6 Results for pramipexole therapy during follow-up of 170 patients
Test (range) | 135th day | 165th day | 205th day |
Hamilton rating scale (0-66) | 9.2 ± 0.1 | 8.7 ± 1.3 | 9.0 ± 1.1 |
(-9.3 ± 3.0; < 0.01) | (-9.8 ± 1.7; < 0.01) | (-9.5 ± 0.2; < 0.01) | |
PSQI (0-5) | 2.2 ± 0.7 | 1.9 ± 0.7 | 2.3 ± 0.7 |
(-1.2 ± 0.2; < 0.05) | (-1.32 ± 0.2; < 0.05) | (-1.1 ± 0.2; < 0.05) | |
ESS (0-24) | 8. 3 ± 0.7 | 8. 5 ± 0.4 | 8 .7 ± 1.1 |
(-7.1 ± 0.4; < 0.01) | (-7.3 ± 0.7; < 0.01) | (-7.7 ± 0.2; < 0.01) | |
IRSL (0-40) | 0-10 (mild) = 51 | 134 | 110 |
11-20 (moderate) = 100 | 12 | 45 | |
21-30 (severe) = 19 | 14 | 15 | |
31-40 (very severe) = 0 | 0 | 0 |
Table 7 Results for gabapentin therapy during follow-up of 41 patients
Test (range) | 135th day | 165th day | 205th day |
Hamilton rating scalec(0-66) | 9.7 ± 0.4 | 9.7 ± 0.5 | 10.0 ± 0.7 |
(-9.8 ± 0.2; < 0.01) | (-9.8 ± 0.3; < 0.01) | (-9.9 ± 1.2; < 0.01) | |
PSQI (0-5) | 2.7 ± 0.7 | 2.9 ± 0.3 | 3.0 ± 0.5 |
(+ 0.7 ± 0.2; NS) | (+0.5 ± 0.2; NS) | (+0.6 ± 0.3; NS) | |
ESS (0-24) | 9 9 ± 0.7 | 9. 5 ± 0.4 | 12 .7 ± 1.1 |
(-0.7 ± 1.0; NS) | (-0.5 ± 0.1; NS) | (-3.3 ± 0.1; < 0.05) | |
IRSL (0-40) | 0-10 (mild) = 21 | 18 | 17 |
11-20 (moderate) = 14 | 19 | 22 | |
21-30 (severe) = 6 | 4 | 2 | |
31-40 (very severe) = 0 | 0 | 0 |
Table 8 Analysis of factors for association with the presence of augmentation
Factor | n | Univariate | Multivariate | ||
OR (95%CI) | P value | OR (95%CI) | P value | ||
Age | 170 | 1.07 (0.7-1.2) | 0.24 | 1.1 (0.9-1.3) | 0.20 |
BMI | 170 | 1.3 (0.9-1.5) | 0.45 | 1.6 (1.0-1.9) | 0.40 |
IRLS | 170 | 1.5 (1.1-2.2) | 0.36 | 1.7 (1.2-2.2) | 0.57 |
Alcohol abuse | 139 | 2.3 (0.9-4.1) | < 0.001 | 3.75 (2.7-6.2) | < 0.001 |
Daily pramipexole | 170 | 3.6 (2.1-6.8) | < 0.001 | 7.2 (4.1-15.2) | < 0.001 |
Treatment duration, > 75 d/< 75 d | 170 | 2.3 (1.3-4.2) | 0.036 | 6.6 (3.1-11.2) | 0.01 |
ALT | 170 | 1.3 (0.9-1.6) | 0.21 | 3.1 (1.7-3.9) | 0.54 |
AST | 170 | 1.6 (0.8-1.7) | 0.50 | 2.7 (0.7-4.2) | 0.76 |
Iron-free level | 170 | 2.9 (0.9-4.1) | 0.01 | 5.05 (1.1-12.2) | 0.06 |
Vit. B12 | 170 | 4.25 (1.3-9.7) | 0.01 | 6.9 (4.7-7.6) | 0.01 |
Folate | 170 | 4.1 (3.1-13.6) | 0.01 | 5.7 (4.2-8.2) | 0.01 |
Vit. D-OH25 | 170 | 4.8 (3.4-12.9) | 0.01 | 5.67 (2.4-8.9) | 0.01 |
- Citation: Moretti R, Caruso P, Tecchiolli M, Gazzin S, Tiribelli C. Management of restless legs syndrome in chronic liver disease: A challenge for the correct diagnosis and therapy. World J Hepatol 2018; 10(3): 379-387
- URL: https://www.wjgnet.com/1948-5182/full/v10/i3/379.htm
- DOI: https://dx.doi.org/10.4254/wjh.v10.i3.379