Abstract
Background: Obstructive sleep apnea (OSA) occurs frequently in hemodialysis (HD) patients with important consequences and increased mortality. However the role of adequacy of HD on the prevalence of OSA is less studied. Objectives: Our aim was to screen OSA and evaluate the effect of HD adequacy on the risk of OSA. Patients and Methods: This is a cross-sectional study on adult HD patients. Clinical and laboratory parameters were collected. The risk of OSA was assessed by STOP-BANG and Berlin questionnaire (BQ). Excessive daytime sleepiness (EDS) was evaluated with Epworth Sleepiness Scale (ESS). Kt/V index was applied for determining HD adequacy. Mortality followed after 2 years. Results: Sixty-five patients (63% men, with a mean age of 53±16.5 years) were included in the study. Most of the subjects were categorized as high risk by Berlin (68.3%) and STOPBANG (84.6%) questionnaires and 25.8% had EDS. Participants who were categorized as high risk of OSA showed lower Kt/V (P=0.018 based on BQ, P=0.002 based on STOPBANG). OSA risk was significantly correlated with Kt/V (OR: 0.007; CI: 0-0.36; p: 0.01). Two-year mortality was not significantly correlated with OSA. Conclusion: OSA was prevalent in our HD patients and correlated with less adequacy of HD. Screening for this common disease by nephrologists using simple questionnaires is recommended.
Highlights
Obstructive sleep apnea (OSA) occurs frequently in hemodialysis (HD) patients with important consequences and increased mortality
Our study suggested OSA is prevalent in our HD patients and could be correlated with adequacy of HD
Descriptive analysis A total number of 65 HD patients (63% men) with mean ± SD age of 53.0 ± 16.5 years were enrolled in the Journal of Nephropathology, Vol 7, No 3, July 2018 www.nephropathol.com obstructive sleep apnea in hemodialysis study
Summary
Obstructive sleep apnea (OSA) occurs frequently in hemodialysis (HD) patients with important consequences and increased mortality. Most of the subjects were categorized as high risk by Berlin (68.3%) and STOPBANG (84.6%) questionnaires and 25.8% had EDS. Conclusion: OSA was prevalent in our HD patients and correlated with less adequacy of HD. Screening for this common disease by nephrologists using simple questionnaires is recommended. End-stage renal disease (ESRD) is a worldwide health problem with increasing prevalence and incidence globally and in Iranian population. 47.7% of Iranian ESRD patients undergo hemodialysis (HD ) as their renal replacement therapy with variable efficacy according to clinical and laboratory parameters. Sleep disorder as a prevalent health problem can adversely affect the quality of life in ESRD patients [3,4]. OSA is a common respiratory sleep disorder in HD patients affecting 30%-80% of this
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