Improvement in sleep apnea during nocturnal peritoneal dialysis is associated with reduced airway congestion and better uremic clearance
| Autor: | Pek-Lan Khong, Kar Neng Lai, Andrew S H Lai, Clara B. Y. Pang, Wai Kuen Tso, Sydney C.W. Tang, Mary S.M. Ip, Bing Lam |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Epidemiology Central apnea medicine.medical_treatment Body water Respiratory System Polysomnography Critical Care and Intensive Care Medicine urologic and male genital diseases Severity of Illness Index Urea - metabolism Peritoneal Dialysis Continuous Ambulatory Electric Impedance Urea Creatinine - metabolism Cross-Over Studies medicine.diagnostic_test Sleep apnea Middle Aged Magnetic Resonance Imaging female genital diseases and pregnancy complications Uremia - etiology - metabolism - pathology - therapy Circadian Rhythm Nephrology Creatinine Cardiology Female Peritoneal Dialysis Adult medicine.medical_specialty Peritoneal Dialysis Continuous Ambulatory - adverse effects Renal function Sleep Apnea Syndromes - etiology - prevention & control Peritoneal dialysis Sleep Apnea Syndromes Internal medicine medicine Humans Aged Uremia Transplantation Peritoneal Dialysis - adverse effects - methods business.industry Continuous ambulatory peritoneal dialysis medicine.disease Respiratory System - pathology Surgery respiratory tract diseases Kinetics Kidney Failure Chronic - complications - metabolism - pathology - therapy Kidney Failure Chronic business Dialysis |
| Zdroj: | Clinical journal of the American Society of Nephrology : CJASN. 4(2) |
| ISSN: | 1555-905X |
| Popis: | Background and objectives: Among peritoneal dialysis (PD) patients, nocturnal PD (NPD) is known to improve sleep apnea compared with continuous ambulatory peritoneal dialysis (CAPD), but the contributing factors are unclear. Design, setting, participants, and measurements: Thirty-eight incident ESRD patients underwent overnight polysomnography (PSG) during NPD and CAPD. Bioelectrical impedance analysis, magnetic resonance imaging of the upper airway, and urea kinetics (Kt/V) during sleep were measured on both occasions. Results: The prevalence of severe sleep apnea (apnea-hypopnea index, AHI ≥ 15/h) was 21.1% during NPD, and 42.1% during CAPD. Mean AHI increased from 9.6 ± 2.7/h during NPD to 21.5 ± 4.2/h during CAPD. Both obstructive and central apnea worsened after conversion to CAPD. NPD achieved greater reductions in total body water, hydration fraction, and net ultrafiltration than CAPD during sleep. Overnight peritoneal Kt/V and creatinine clearance were lower after conversion. Both peritoneal Kt/V and peritoneal creatinine clearance correlated with AHI, as did their changes after conversion. Volumetric magnetic resonance imaging revealed reduced pharyngeal volumes and cross-sectional area, and tongue enlargement after conversion. Conclusions: Improvement in sleep apnea during NPD versus CAPD is associated with better fluid and uremic clearance and reduced upper airway congestion during sleep. Copyright © 2009 by the American Society of Nephrology. link_to_OA_fulltext |
| Databáze: | OpenAIRE |
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