The predictors of central and obstructive sleep apnoea in haemodialysis patients

Tada, Takeshi; Kusano, Kengo; Ogawa, Aiko; Iwasaki, Jun; Sakuragi, Satoru; Kusano, Isao; Takatsu, Seiko; Miyazaki, Masashi; Ohe, Tohru

doi:10.1093/ndt/gfl748

Cited by 92 publications

(59 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings support that the prevalence and severity of OSA among nondialysis CKD patients is considerably higher than those in the general population, in which 1 of 5 adults suffers mild OSA and 1 of 15 has moderate OSA (1). The number of central sleep apnea events in our population was modest and comparable to or slightly less than that previously observed among hemodialysis patients (20,21). It is notable that in this study subjects were enrolled irrespective of sleep complaints and showed a high prevalence of OSA.…”

Section: Discussionsupporting

confidence: 66%

High Prevalence of Obstructive Sleep Apnea and Its Association with Renal Function among Nondialysis Chronic Kidney Disease Patients in Japan

Sakaguchi

Tanaka

Kawabata

et al. 2011

Clinical Journal of the American Society of Nephrology

121

View full text Add to dashboard Cite

SummaryBackground and objectives Obstructive sleep apnea (OSA) affects one of five adults in the general population. Although a high prevalence of OSA has been reported among dialysis patients, the association between nondialysis chronic kidney disease (CKD) and OSA has not been fully investigated. This cross-sectional study aimed to investigate the prevalence of OSA among nondialysis CKD patients in Japan and the association between renal function and OSA.Design, setting, participants, & measurements Consecutive nondialysis CKD patients hospitalized mainly for CKD educational program, regardless of their sleep complaints, were enrolled. The diagnosis of OSA and its severity were measured using a type 3 portable monitor.Results Overall (n ϭ 100, 68.0% male, median age 66.5 years, body mass index [BMI] 23.1 kg/m 2 , estimated GFR [eGFR] 28.5 ml/min per 1.73 m 2 ), 65% were diagnosed as OSA: mild OSA (apnea-hypopnea index [AHI] 5.0 to 14.9) in 32%, moderate OSA (AHI 15.0 to 29.9) in 25%, and severe OSA (AHI Ն 30.0) in 8%. Multivariate logistic regression analysis revealed that a 10-ml/min per 1.73 m 2 decrease in eGFR was associated with a 42% increased odds of OSA after adjustment for age, BMI, and diabetes mellitus. Moreover, in a generalized linear model, eGFR was inversely correlated with AHI after adjustment for covariates.Conclusions This study demonstrated a high prevalence of OSA among nondialysis CKD patients in Japan and that the increased risk of OSA was significantly associated with decreased GFR among these patients. Further investigations are warranted to determine OSA's direct influence on cardiovascular disease.

show abstract

Section: Discussionsupporting

confidence: 66%

High Prevalence of Obstructive Sleep Apnea and Its Association with Renal Function among Nondialysis Chronic Kidney Disease Patients in Japan

Sakaguchi

Tanaka

Kawabata

et al. 2011

Clinical Journal of the American Society of Nephrology

121

View full text Add to dashboard Cite

show abstract

“…They found a meaningful relation between the neck base circumference and the incidence of sleep apnea syndrome (25). The prevalence of the sleep apnea syndrome reported in previous studies ranges between 11.8% and 73.5% (2,4,10,20,26). In our study, 23.19% of the patients had experienced sleep apnea syndrome.…”

mentioning

confidence: 47%

Sleep Quality in Patients Undergoing Long-term Hemodialysis Using the Pittsburgh Sleep Quality Index

2017

View full text Add to dashboard Cite

Background: Sleep disturbances are common among uremic patients. However, limited data are available on predictors of the quality of sleep in this population. Objectives: This study aimed to assess the quality of sleep in patients undergoing hemodialysis and investigate its predictors. Methods: In this cross-sectional study, 197 patients on maintenance hemodialysis were consecutively included from three medical centers in Shiraz, southern Iran. They completed the Pittsburgh sleep quality index. Serum calcium, phosphorus, and hemoglobin levels were checked. We also assessed the neck circumference, dialysis shift, dialysis plan, diabetes history, body mass index (BMI), age, and sex.

show abstract

“…156 Volume overload and the specific redistribution described in patients with ESRD may be not only a consequence but also an important cause of obstructive sleep apnea. 157 …”

Section: Nonvolume-dependent Causes Of Hypertension In Dialysis Patientsmentioning

confidence: 99%

Assessment and Management of Hypertension in Patients on Dialysis

Agarwal

Flynn

Pogue

et al. 2014

Journal of the American Society of Nephrology

157

156

View full text Add to dashboard Cite

Hypertension is common, difficult to diagnose, and poorly controlled among patients with ESRD. However, controversy surrounds the diagnosis and treatment of hypertension. Here, we describe the diagnosis, epidemiology, and management of hypertension in dialysis patients, and examine the data sparking debate over appropriate methods for diagnosing and treating hypertension. Furthermore, we consider the issues uniquely related to hypertension in pediatric dialysis patients. Future clinical trials designed to clarify the controversial results discussed here should lead to the implementation of diagnostic and therapeutic techniques that improve long-term cardiovascular outcomes in patients with ESRD. Hypertension is common among patients with ESRD. In this review, we discuss the diagnosis, epidemiology, and management of hypertension among dialysis patients. We also review areas of existing controversies and briefly discuss the issue of hypertension in pediatric dialysis patients. EPIDEMIOLOGYThe prevalence, treatment, and control of hypertension among people on hemodialysis (HD) have used varying definitions to diagnose hypertension. The epidemiology differs based on how BP is measured: either before and after dialysis or using ambulatory BP recordings. Epidemiology with Routine BP MeasurementsThe prevalence of hypertension (defined as 1-week average predialysis systolic BP [SBP] measurements .150 mmHg or diastolic BP [DBP].85 mmHg or the use of antihypertensive medications) was 86% among 2535 clinically stable adult HD patients participating in a multicenter trial. 1 Among hypertensive patients, 12% did not receive antihypertensive drugs, 58% were treated but not controlled, and only 30% were controlled. The use of antihypertensive drugs has been reported to vary from 59% to 83%. [2][3][4][5] Furthermore, even among children on long-term HD, similar findings have been reported. 6 Several studies have confirmed greater antihypertensive drug use to be associated with poorer control. 7,8 It should be noted that antihypertensive drug use per se do not lead to worse BP control; in the absence of adequate volume control, increasing antihypertensive drug use may simply reflect difficult-to-control BP. Epidemiology Using Ambulatory BP MeasurementsThe prevalence of hypertension (defined by either a 44-hour interdialytic ambulatory BP of $135/85 mmHg or the prescription of any antihypertensive agent) was 86% among 369 chronic HD patients. 8 Although hypertension was being treated with antihypertensive drugs in 89% of patients, it was adequately controlled only in 38%. The independent determinants of poor control were the use of antihypertensive drugs and an expanded extracellular volume state. If patients were volume overloaded, nearly 80% became hypertensive when medications were Published online ahead of print. Publication date available at www.jasn.org.

show abstract

The predictors of central and obstructive sleep apnoea in haemodialysis patients

Cited by 92 publications

References 20 publications

High Prevalence of Obstructive Sleep Apnea and Its Association with Renal Function among Nondialysis Chronic Kidney Disease Patients in Japan

High Prevalence of Obstructive Sleep Apnea and Its Association with Renal Function among Nondialysis Chronic Kidney Disease Patients in Japan

Sleep Quality in Patients Undergoing Long-term Hemodialysis Using the Pittsburgh Sleep Quality Index

Assessment and Management of Hypertension in Patients on Dialysis

Contact Info

Product

Resources

About