Restless Legs Syndrome Could Indicate Biotin Deficiencies in Dialysis Patients

Restless Legs Syndrome Could Indicate Biotin Deficiencies in Patients on Dialysis: Presented at NKF

By Carole VanSickle Ellis

ORLANDO, Fla -- April 19, 2010 -- According to a study presented here April 15 at the National Kidney Foundation (NKF) 2010 Spring Clinical Meetings, restless legs syndrome (RLS) is extremely prevalent among biotin-deficient dialysis patients, and may actually be an indication of the deficiency.

"Until recently, studies of biotin status of dialysis patients were problematic because biotin status is assessed using an index that does not depend directly on renal function," according to Heidi Moretti, Saint Patrick Hospital and Health Sciences, Missoula, Montana, and colleagues.

Recent studies indicate that propionyl-CoA carboxylase (PCC) a biotin-requiring enzyme that reflects intracellular biotin status, and its activity could be sensitive, specific indicators of biotin status in chronic dialysis patients.

The original intent of the study was to "quantify and compare PCC and PCC activation coefficients" of a control group and a study group. In the process, the relationship of RLS to these biomarkers was also tracked.

A total of 70 patients participated in the study. The team diagnosed RLS using the International RLS Scale, while PCC activity was charted in both the healthy group and the study group.

While PCC activity between these groups was not significantly different, the PCC activation coefficient (AC) in 31% (19 of 61 in the test group) of the patients was greater than 1, suggesting impaired biotin status.

In the group with RLS, PCC AC was determined to be significantly greater compared with the other groups (P = .012), and the biotin deficiency was also determined to be larger in scale as a result. In the dialysis group, RLS was evident in 57% (35 of 61 subjects) of the patients.

The team determined based on these results that biotin supplementation might prove to be a viable treatment option for dialysis patients with RLS. However, the group did note the small size of the study as a limitation.

[Presentation Title: Biotin Deficiency and Restless Legs Syndrome in Dialysis. Abstract 263]

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