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Article: Sleep apnea is a novel risk predictor of cardiovascular morbidity and death in patients receiving peritoneal dialysis

TitleSleep apnea is a novel risk predictor of cardiovascular morbidity and death in patients receiving peritoneal dialysis
Authors
Keywordscardiovascular morbidity
peritoneal dialysis
sleep apnea
survival
Issue Date2010
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.html
Citation
Kidney International, 2010, v. 77 n. 11, p. 1031-1038 How to Cite?
AbstractSleep apnea syndrome is increasingly recognized in peritoneal dialysis patients; however, its prognostic implication in this population is unknown. To study this, we prospectively followed the clinical outcome of 93 peritoneal dialysis patients with baseline polysomnography. Of these, 51 were diagnosed with the syndrome defined by an apnea-hypopnea index (AHI) of at least 15 per hour. During a median follow-up of 41 months, there were 30 deaths, of which 17 were due to cardiovascular causes. Kaplan-Meier analysis for the entire follow-up period indicated that patients with sleep apnea at baseline had significantly higher all-cause and cardiovascular mortality during follow-up than those without. Minimal nocturnal saturation and desaturation indices were predictors of mortality and cardiovascular events at univariate analysis. Multivariable Cox regression analysis identified significant sleep apnea syndrome at baseline as an independent predictor of increased all-cause mortality independent of age, male gender, and diabetic status. Further, an absolute increase in the AHI was associated with an incremental risk of cardiovascular events. Thus, sleep apnea syndrome, detected at the start of peritoneal dialysis, is a novel risk predictor for subsequent mortality and cardiovascular events. © 2010 International Society of Nephrology.
Persistent Identifierhttp://hdl.handle.net/10722/129536
ISSN
2014 Impact Factor: 8.563
2014 SCImago Journal Rankings: 2.808
ISI Accession Number ID
Funding AgencyGrant Number
University of Hong Kong
Funding Information:

This study is supported by the Seed Funding Programme for Basic Research of the University of Hong Kong. We are grateful to Agnes Lai and Barbara Law (Sleep Laboratory), Sandra Luen (Division of Nephrology), Helena Leung and all nursing staff (K18N Dialysis Unit, QMH), WO Lam and all nursing staff (14B Dialysis Unit, UCH) for coordinating the PSG studies, Jack Lam and Jennifer Cheung (Sleep Laboratory) for scoring all PSGs manually, and Suki Ho (Dialysis Unit) for performing all urea kinetics computations. Part of the results from this study were presented in abstract form at the 4th Asian Chapter Meeting of the International Society for Peritoneal Dialysis in Beijing, China, Oct 15-17, 2009.

References

 

DC FieldValueLanguage
dc.contributor.authorTang, SCWen_HK
dc.contributor.authorLam, Ben_HK
dc.contributor.authorYao, TJen_HK
dc.contributor.authorLeung, WSen_HK
dc.contributor.authorChu, CMen_HK
dc.contributor.authorHo, YWen_HK
dc.contributor.authorIp, MSMen_HK
dc.contributor.authorLai, KNen_HK
dc.date.accessioned2010-12-23T08:38:37Z-
dc.date.available2010-12-23T08:38:37Z-
dc.date.issued2010en_HK
dc.identifier.citationKidney International, 2010, v. 77 n. 11, p. 1031-1038en_HK
dc.identifier.issn0085-2538en_HK
dc.identifier.urihttp://hdl.handle.net/10722/129536-
dc.description.abstractSleep apnea syndrome is increasingly recognized in peritoneal dialysis patients; however, its prognostic implication in this population is unknown. To study this, we prospectively followed the clinical outcome of 93 peritoneal dialysis patients with baseline polysomnography. Of these, 51 were diagnosed with the syndrome defined by an apnea-hypopnea index (AHI) of at least 15 per hour. During a median follow-up of 41 months, there were 30 deaths, of which 17 were due to cardiovascular causes. Kaplan-Meier analysis for the entire follow-up period indicated that patients with sleep apnea at baseline had significantly higher all-cause and cardiovascular mortality during follow-up than those without. Minimal nocturnal saturation and desaturation indices were predictors of mortality and cardiovascular events at univariate analysis. Multivariable Cox regression analysis identified significant sleep apnea syndrome at baseline as an independent predictor of increased all-cause mortality independent of age, male gender, and diabetic status. Further, an absolute increase in the AHI was associated with an incremental risk of cardiovascular events. Thus, sleep apnea syndrome, detected at the start of peritoneal dialysis, is a novel risk predictor for subsequent mortality and cardiovascular events. © 2010 International Society of Nephrology.en_HK
dc.languageengen_US
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.htmlen_HK
dc.relation.ispartofKidney Internationalen_HK
dc.subjectcardiovascular morbidityen_HK
dc.subjectperitoneal dialysisen_HK
dc.subjectsleep apneaen_HK
dc.subjectsurvivalen_HK
dc.titleSleep apnea is a novel risk predictor of cardiovascular morbidity and death in patients receiving peritoneal dialysisen_HK
dc.typeArticleen_HK
dc.identifier.emailTang, SCW: scwtang@hku.hken_HK
dc.identifier.emailIp, MSM: msmip@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityTang, SCW=rp00480en_HK
dc.identifier.authorityIp, MSM=rp00347en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1038/ki.2010.76en_HK
dc.identifier.scopuseid_2-s2.0-77955863860en_HK
dc.identifier.hkuros176963en_US
dc.identifier.hkuros173977-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77955863860&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume77en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1031en_HK
dc.identifier.epage1038en_HK
dc.identifier.isiWOS:000277626700012-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTang, SCW=7403437082en_HK
dc.identifier.scopusauthoridLam, B=9246012800en_HK
dc.identifier.scopusauthoridYao, TJ=55194401400en_HK
dc.identifier.scopusauthoridLeung, WS=7201504471en_HK
dc.identifier.scopusauthoridChu, CM=7404345558en_HK
dc.identifier.scopusauthoridHo, YW=7402555047en_HK
dc.identifier.scopusauthoridIp, MSM=7102423259en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK

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