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Conference Paper: Impact of nephrotic leg edema on OSA: gathering a unifying concept for the pathogenetic role of nocturnal rostral fluid shift

TitleImpact of nephrotic leg edema on OSA: gathering a unifying concept for the pathogenetic role of nocturnal rostral fluid shift
Authors
Issue Date2010
PublisherAmerican Society of Nephrology. The Journal's web site is located at https://www.asn-online.org/abstracts/
Citation
Renal Week 2010, Denver, CO., 16-21 November 2010. In Journal of the American Society of Nephrology, 2010, v. 21, p. 417A, abstract no. F-PO1339 How to Cite?
Abstract
RATIONALE: Nocturnal rostral fluid shift has been suggested to be a risk factor for obstructive sleep apnea (OSA) in healthy subjects after lower body positive pressurization and in heart failure subjects. Here, we tested whether this may apply to nephrotic lower limb edema and whether remission of the nephrotic syndrome may reverse OSA. METHODS: In subjects with primary steroid-responsive nephrotic syndrome presenting with bilateral lower limb edema, we examined the prevalence and severity of sleep apnea and related parameters before and after the induction of disease remission. MEASUREMENTS AND MAIN RESULTS: Among 16 nephrotic subjects, 7 (43.7%) had sleep apnea (apnea-hypopnea index [AHI]>5) upon presentation. Overall AHI was 14.8±5.0 and was predominantly obstructive in nature. After steroid-based treatment, there was remission of proteinuria associated with complete disappearance of lower limb edema, significant reduction of body mass index, waist, hip and calf circumferences, and total body water mainly in the extracellular compartment. Polysomnographic analyses, performed 8.3±2.8 months after initial presentation, showed improvement in sleep efficiency (P=0.036), mean nocturnal oxygen saturation (P=0.005), shorter duration with oxygen saturation <95% (P=0.044) and <90% (P=0.02), and reduced desaturation index (P=0.011). AHI reduction was close to statistical significance, particularly when confined to subjects with baseline AHI> 5 (P=0.075). There was subjective improvement in self-reported daytime sleepiness (P=0.03). CONCLUSIONS: Nephrotic lower limb edema is a risk factor for nocturnal hypoxemia and possibly also for OSA. This gathers a unifying concept for the pathogenetic role of nocturnal rostral fluid shift in OSA.
DescriptionFriday Poster Presentation - Clinical Immunology, Pathology: Diagnostic Renal Pathology: no. F-PO1339
Persistent Identifierhttp://hdl.handle.net/10722/137788
ISSN
2013 Impact Factor: 9.466

 

DC FieldValueLanguage
dc.contributor.authorTang, SCWen_US
dc.contributor.authorLam, Ben_US
dc.contributor.authorLam, JCen_US
dc.contributor.authorYap, DYHen_US
dc.contributor.authorIp, MSMen_US
dc.contributor.authorLai, KNen_US
dc.date.accessioned2011-08-26T14:33:24Z-
dc.date.available2011-08-26T14:33:24Z-
dc.date.issued2010en_US
dc.identifier.citationRenal Week 2010, Denver, CO., 16-21 November 2010. In Journal of the American Society of Nephrology, 2010, v. 21, p. 417A, abstract no. F-PO1339en_US
dc.identifier.issn1046-6673-
dc.identifier.urihttp://hdl.handle.net/10722/137788-
dc.descriptionFriday Poster Presentation - Clinical Immunology, Pathology: Diagnostic Renal Pathology: no. F-PO1339-
dc.description.abstractRATIONALE: Nocturnal rostral fluid shift has been suggested to be a risk factor for obstructive sleep apnea (OSA) in healthy subjects after lower body positive pressurization and in heart failure subjects. Here, we tested whether this may apply to nephrotic lower limb edema and whether remission of the nephrotic syndrome may reverse OSA. METHODS: In subjects with primary steroid-responsive nephrotic syndrome presenting with bilateral lower limb edema, we examined the prevalence and severity of sleep apnea and related parameters before and after the induction of disease remission. MEASUREMENTS AND MAIN RESULTS: Among 16 nephrotic subjects, 7 (43.7%) had sleep apnea (apnea-hypopnea index [AHI]>5) upon presentation. Overall AHI was 14.8±5.0 and was predominantly obstructive in nature. After steroid-based treatment, there was remission of proteinuria associated with complete disappearance of lower limb edema, significant reduction of body mass index, waist, hip and calf circumferences, and total body water mainly in the extracellular compartment. Polysomnographic analyses, performed 8.3±2.8 months after initial presentation, showed improvement in sleep efficiency (P=0.036), mean nocturnal oxygen saturation (P=0.005), shorter duration with oxygen saturation <95% (P=0.044) and <90% (P=0.02), and reduced desaturation index (P=0.011). AHI reduction was close to statistical significance, particularly when confined to subjects with baseline AHI> 5 (P=0.075). There was subjective improvement in self-reported daytime sleepiness (P=0.03). CONCLUSIONS: Nephrotic lower limb edema is a risk factor for nocturnal hypoxemia and possibly also for OSA. This gathers a unifying concept for the pathogenetic role of nocturnal rostral fluid shift in OSA.-
dc.languageengen_US
dc.publisherAmerican Society of Nephrology. The Journal's web site is located at https://www.asn-online.org/abstracts/-
dc.relation.ispartofJASN Abstract Supplementen_US
dc.titleImpact of nephrotic leg edema on OSA: gathering a unifying concept for the pathogenetic role of nocturnal rostral fluid shiften_US
dc.typeConference_Paperen_US
dc.identifier.emailTang, SCW: scwtang@hku.hken_US
dc.identifier.emailLam, B: lambing@hkucc.hku.hken_US
dc.identifier.emailYap, DYH: desmondy@hku.hken_US
dc.identifier.emailIp, MSM: msmip@hku.hken_US
dc.identifier.emailLai, KN: knlai@hku.hk-
dc.identifier.authorityTang, SCW=rp00480en_US
dc.identifier.authorityYap, DYH=rp01607en_US
dc.identifier.authorityIp, MSM=rp00347en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.hkuros191018en_US
dc.identifier.volume21en_US
dc.identifier.spage417A, abstract no. F-PO1339en_US
dc.identifier.epage417A, abstract no. F-PO1339en_US
dc.publisher.placeUnited States-

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