Article: Sleep apnea is a novel risk predictor of cardiovascular morbidity and death in patients receiving peritoneal dialysis
| Title | Sleep apnea is a novel risk predictor of cardiovascular morbidity and death in patients receiving peritoneal dialysis | ||||
|---|---|---|---|---|---|
| Authors | Tang, SCW1 2 Lam, B1 Yao, TJ1 Leung, WS2 Chu, CM2 Ho, YW2 Ip, MSM1 Lai, KN1 | ||||
| Keywords | cardiovascular morbidity peritoneal dialysis sleep apnea survival | ||||
| Issue Date | 2010 | ||||
| Publisher | Nature 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?] DOI: http://dx.doi.org/10.1038/ki.2010.76 | ||||
| Abstract | Sleep 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. | ||||
| ISSN | 0085-2538 2011 Impact Factor: 6.606 2011 SCImago Journal Rankings: 0.488 | ||||
| DOI | http://dx.doi.org/10.1038/ki.2010.76 | ||||
| ISI Accession Number ID | WOS:000277626700012
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 | References in Scopus |
| dc.contributor.author | Tang, SCW | ||||
|---|---|---|---|---|---|
| dc.contributor.author | Lam, B | ||||
| dc.contributor.author | Yao, TJ | ||||
| dc.contributor.author | Leung, WS | ||||
| dc.contributor.author | Chu, CM | ||||
| dc.contributor.author | Ho, YW | ||||
| dc.contributor.author | Ip, MSM | ||||
| dc.contributor.author | Lai, KN | ||||
| dc.date.accessioned | 2010-12-23T08:38:37Z | ||||
| dc.date.available | 2010-12-23T08:38:37Z | ||||
| dc.date.issued | 2010 | ||||
| dc.description.abstract | Sleep 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. | ||||
| dc.description.nature | Link_to_subscribed_fulltext | ||||
| dc.identifier.citation | Kidney International, 2010, v. 77 n. 11, p. 1031-1038 [How to Cite?] DOI: http://dx.doi.org/10.1038/ki.2010.76 | ||||
| dc.identifier.doi | http://dx.doi.org/10.1038/ki.2010.76 | ||||
| dc.identifier.epage | 1038 | ||||
| dc.identifier.hkuros | 176963 | ||||
| dc.identifier.isi | WOS:000277626700012
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. | ||||
| dc.identifier.issn | 0085-2538 2011 Impact Factor: 6.606 2011 SCImago Journal Rankings: 0.488 | ||||
| dc.identifier.issue | 11 | ||||
| dc.identifier.scopus | eid_2-s2.0-77955863860 | ||||
| dc.identifier.spage | 1031 | ||||
| dc.identifier.uri | http://hdl.handle.net/10722/129536 | ||||
| dc.identifier.volume | 77 | ||||
| dc.language | eng | ||||
| dc.publisher | Nature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.html | ||||
| dc.publisher.place | United Kingdom | ||||
| dc.relation.ispartof | Kidney International | ||||
| dc.relation.references | References in Scopus | ||||
| dc.subject | cardiovascular morbidity | ||||
| dc.subject | peritoneal dialysis | ||||
| dc.subject | sleep apnea | ||||
| dc.subject | survival | ||||
| dc.title | Sleep apnea is a novel risk predictor of cardiovascular morbidity and death in patients receiving peritoneal dialysis | ||||
| dc.type | Article |
- The University of Hong Kong
- United Christian Hospital Hong Kong