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Sleep Disorders |

Sleep Apnea in Egyptian Patients With End Stage Renal Disease: Effect of Hemodialysis

Eman Hatata, MBBCh; Montasser Zeid, MBBCh; Sahar Mourad, MBBCh; Nashwa AbdelWahab, MBBCh; Heba Kotb, MBBCh
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Chest Diseases Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt


Chest. 2014;146(4_MeetingAbstracts):943A. doi:10.1378/chest.1994760
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Abstract

SESSION TITLE: Sleep Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The aim of this work was to study the effect of regular conventional heamdialysis (CHD) (3 times/ week) on sleep related breathing disorders (SRBD) in patient with end stage renal disease (ESRD)

METHODS: This study included 15 patients with ESRD on CHD and have evidence of SRBD. In addition to full clinical examination and laboratory investigations, limited sleep study (level IV) was performed to all patients (the day before and day after the setting of dialysis). Manual scoring was performed according to criteria established by the American Academy of Sleep Medicine 2007.

RESULTS: Weight of the studied patients decreased significantly from 80.3±15.1 kg before to 77.1±14.6 kg after dialysis ( P<0.0001*). Both Systolic and diastolic blood pressure decreased from 140.7±21.2 and 88.0±5.6 before dialysis to 122.0±22.4 and 76.0±11.2 mmHg after dialysis (P<0.0001, P<0.002). The apnea hyponea index (AHI) decreased significantly from 35.1±22.3 before to 15.1±14.9/hour after dialysis (P<0.0001). Mean SaO2 increased significantly from 94.3±2.5 before to 95.8±1.6% after dialysis (P<0.042). Minimal SaO2 mean increased significantly from 39.1±36.4 before to 82.3±9.8% after dialysis (P<0.0001). The t 90% decreased from 6.7±12.6% before to 1.8±5.1% after dialysis (P<0.016). AHI showed a statistically significant direct correlation with each of blood urea nitrogen levels (BUN) (r=.441, p=.015) and serum creatinine level (r=.454, p=.012). Blood urea nitrogen levels (BUN) showed statistically significant inverse correlation with basal oxygen saturation (r= -.397, p=.030) and direct correlation with each of systolic and diastolic blood pressure (r=.372, p=.043), (r=.581, p=.001) respectively.

CONCLUSIONS: In patients with end stage renal disease (ESRD) the altered biochemical milieu due to uremic toxins and fluid overload may contribute to sleep related breathing disorder (SRBD). As well, uremia clearance and elimination of excess fluid during CHD is associated with significant improvement in SA. However, it is also possible that there is bi-directional causality such that SRBD also contributes to the progression of kidney disease.

CLINICAL IMPLICATIONS: Screening for SRDB should be a part of assessment of patients with ESRD, for early detection and proper management of SRDB, aiming to reduce related morbidity and mortality in those patients

DISCLOSURE: The following authors have nothing to disclose: Eman Hatata, Montasser Zeid, Sahar Mourad, Nashwa AbdelWahab, Heba Kotb

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