Obstructive Sleep Apnea Severity and Overnight Body Fluid Shift before and after Hemodialysis.

Détails

ID Serval
serval:BIB_24E31BAB288B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Obstructive Sleep Apnea Severity and Overnight Body Fluid Shift before and after Hemodialysis.
Périodique
Clinical Journal of the American Society of Nephrology : Cjasn
Auteur(s)
Ogna A., Forni Ogna V., Mihalache A., Pruijm M., Halabi G., Phan O., Cornette F., Bassi I., Haba Rubio J., Burnier M., Heinzer R.
ISSN
1555-905X (Electronic)
ISSN-L
1555-9041
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
10
Numéro
6
Pages
1002-1010
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
BACKGROUND AND OBJECTIVES: Obstructive sleep apnea is associated with significantly increased cardiovascular morbidity and mortality. Fluid overload may promote obstructive sleep apnea in patients with ESRD through an overnight fluid shift from the legs to the neck soft tissues. Body fluid shift and severity of obstructive sleep apnea before and after hemodialysis were compared in patients with ESRD.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Seventeen patients with hemodialysis and moderate to severe obstructive sleep apnea were included. Polysomnographies were performed the night before and after hemodialysis to assess obstructive sleep apnea, and bioimpedance was used to measure fluid overload and leg fluid volume.
RESULTS: The mean overnight rostral fluid shift was 1.27±0.41 L prehemodialysis; it correlated positively with fluid overload volume (r=0.39; P=0.02) and was significantly lower posthemodialysis (0.78±0.38 L; P<0.001). There was no significant difference in the mean obstructive apnea-hypopnea index before and after hemodialysis (46.8±22.0 versus 42.1±18.6 per hour; P=0.21), but obstructive apnea-hypopnea index was significantly lower posthemodialysis (-10.1±10.8 per hour) in the group of 12 patients, with a concomitant reduction of fluid overload compared with participants without change in fluid overload (obstructive apnea-hypopnea index +8.2±16.1 per hour; P<0.01). A lower fluid overload after hemodialysis was significantly correlated (r=0.49; P=0.04) with a lower obstructive apnea-hypopnea index. Fluid overload-assessed by bioimpedance-was the best predictor of the change in obstructive apnea-hypopnea index observed after hemodialysis (standardized r=-0.68; P=0.01) in multivariate regression analysis.
CONCLUSIONS: Fluid overload influences overnight rostral fluid shift and obstructive sleep apnea severity in patients with ESRD undergoing intermittent hemodialysis. Although no benefit of hemodialysis on obstructive sleep apnea severity was observed in the whole group, the change in obstructive apnea-hypopnea index was significantly correlated with the change in fluid overload after hemodialysis. Moreover, the subgroup with lower fluid overload posthemodialysis showed a significantly lower obstructive sleep apnea severity, which provides a strong incentive to further study whether optimizing fluid status in patients with obstructive sleep apnea and ESRD will improve the obstructive apnea-hypopnea index.
Mots-clé
Aged, Body Composition, Electric Impedance, Female, Fluid Shifts, Humans, Kidney Failure, Chronic/complications, Kidney Failure, Chronic/diagnosis, Male, Middle Aged, Polysomnography, Predictive Value of Tests, Renal Dialysis, Risk Factors, Severity of Illness Index, Sleep Apnea, Obstructive/complications, Sleep Apnea, Obstructive/diagnosis, Switzerland, Treatment Outcome
Pubmed
Web of science
Open Access
Oui
Création de la notice
06/07/2015 14:33
Dernière modification de la notice
20/08/2019 14:03
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