Journal
NEPHROLOGY DIALYSIS TRANSPLANTATION
Volume 27, Issue 4, Pages 1569-1573Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ndt/gfr605
Keywords
fluid shift; end-stage renal disease; obstructive sleep apnea
Categories
Funding
- Canadian Institutes of Health Research [MOP-82731]
- Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES), Brazil, Toronto Rehabilitation Institute
- Fuji-Respironics Inc.
- Toronto Rehabilitation Institute
- R. Fraser Elliott Chair in Home Dialysis
Ask authors/readers for more resources
Background. In both healthy male subjects and men with heart failure, the severity of obstructive sleep apnea (OSA) is related to the amount of fluid displaced from their legs into the neck overnight. Whether overnight rostral fluid shift contributes to the pathogenesis of OSA in patients with end-stage renal disease (ESRD) is unknown. We hypothesized that the change in neck circumference (NC) and severity of OSA are related to the extent of overnight change in leg fluid volume (LFV) in patients with ESRD. Methods. We studied 26 patients with ESRD (14 men) on conventional hemodialysis. All subjects underwent polysomnography. LFV was measured by bioelectric impedance at bedtime and repeated in the next morning on awakening. Results. Our cohort's overall apnea-hypopnea index was 22.8 +/- 26.8 episodes/h of sleep. Their overnight change in LFV was -243 +/- 278 mL. The change in LFV correlated with apnea-hypopnea time (AHT) (P = 0.001) and NC (P = 0.0016). Other independent factors associated with AHT included age (P = 0.005), baseline neck (P = 0.0002), sitting time (P = 0.008) and male gender. Stepwise multiple regression analysis revealed that age, change in LFV and male gender remained independent related to AHT. Conclusions. Nocturnal rostral fluid shift is associated with the severity of OSA in ESRD. Prospective evaluation of the effect of reducing fluid overload and severity of OSA in ESRD patients warrants further examination.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available