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Sleep apnea in patients on conventional thrice-weekly hemodialysis: comparison with matched controls from the Sleep Heart Health Study.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | Sleep apnea in patients on conventional thrice-weekly hemodialysis: comparison with matched controls from the Sleep Heart Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2006 |
| Authors | Unruh, ML, Sanders, MH, Redline, S, Piraino, BM, Umans, JG, Hammond, TC, Sharief, I, Punjabi, NM, Newman, AB |
| Journal | J Am Soc Nephrol |
| Volume | 17 |
| Issue | 12 |
| Pagination | 3503-9 |
| Date Published | 2006 Dec |
| ISSN | 1046-6673 |
| Keywords | Blood Pressure, Body Mass Index, Cardiovascular Diseases, Case-Control Studies, Cross-Sectional Studies, Diabetes Mellitus, Female, Humans, Kidney Failure, Chronic, Male, Middle Aged, Prevalence, Renal Dialysis, Severity of Illness Index, Sleep Apnea Syndromes |
| Abstract | <p>Sleep-disordered breathing (SDB) has been noted commonly in hemodialysis (HD) patients, but it is not known whether this is related directly to the treatment of kidney failure with HD or to the higher prevalence of obesity and older age. Forty-six HD patients were compared with 137 participants from the Sleep Heart Health Study (SHHS) who were matched for age, gender, body mass index (BMI), and race. Home unattended polysomnography was performed and scored using similar protocols. The study sample was 62.7 +/- 10.1 yr, was predominantly male (72%) and white (63%), and had an average BMI of 28 +/- 5.3 kg/m(2). The HD sample had a higher systolic BP (137 versus 121 mmHg; P < 0.01) and a higher prevalence of diabetes (33 versus 9%; P < 0.01) and cardiovascular disease (33 versus 13%; P < 0.01) compared with the SHHS sample. The HD group had significantly less sleep time (320 versus 379 min; P < 0.0001) but similar sleep efficiency. HD patients had a higher frequency of arousals per hour (25.1 versus 17.1; P < 0.0001) and apnea-hypopneas per hour (27.2 versus 15.2; P < 0.0001) and greater percentage of the total sleep time below an oxygen saturation of 90% (7.2 versus 1.8; P < 0.0001). HD patients were more likely to have severe SDB (>30 respiratory events per hour) compared with the SHHS sample (odds ratio 4.07; 95% confidence interval 1.83 to 9.07). There was a strong association of HD with severe SDB and nocturnal hypoxemia independent of age, BMI, and the higher prevalence of chronic disease. The potential mechanisms for the higher likelihood of SDB in the HD population must be identified to provide specific prevention and therapy.</p> |
| DOI | 10.1681/ASN.2006060659 |
| Alternate Journal | J Am Soc Nephrol |
| PubMed ID | 17082238 |
| Grant List | DK66006 / DK / NIDDK NIH HHS / United States M01RR000056 / RR / NCRR NIH HHS / United States U01HL53916 / HL / NHLBI NIH HHS / United States U01HL53931 / HL / NHLBI NIH HHS / United States U01HL53934 / HL / NHLBI NIH HHS / United States U01HL53937 / HL / NHLBI NIH HHS / United States U01HL53938 / HL / NHLBI NIH HHS / United States U01HL53940 / HL / NHLBI NIH HHS / United States U01HL53941 / HL / NHLBI NIH HHS / United States U01HL63429 / HL / NHLBI NIH HHS / United States U01HL63463 / HL / NHLBI NIH HHS / United States U01HL64360 / HL / NHLBI NIH HHS / United States |