Conversion between hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) may impact on sleep apnea in favor of CAPD

Abstract

Study Objective: To investigate the potential difference in impact on sleep apnea between continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) therapy in end-stage renal disease (ESRD) patients. Patients and Methods: Six patients (2 males, mean age 64.3 6.8 years, 4 had diabetes, 1 had lupus, and 1 had vasculitis as cause of renal failure) underwent standard overnight polysomnography during CAPD and then HD sequentially, or vice versa. The reasons for switching from CAPD to HD were membrane failure in 1, refractory peritonitis in 3, hernia operation in 1, and perforated colon in 1. The mean ( SE) apnea-hypopnea index (AHI), defined as the frequency of apnea and hypopnea per hour of sleep, during HD and CAPD was 34.1 13.0 and 7.9 3.61/hour (P=0.1), respectively. The obstructive apnea index was 13.4 7.1 vs. 7.1 2.6/hour, and the central apnea index was 20.7 13.7 vs. 0.8 0.4/hour during HD and CAPD, respectively. Five patients (83%) had reduction in AHI on switching from HD to CAPD, and this was mainly due to a reduction in the central component of sleep apnea. Conclusion: There is a trend toward reduced severity of sleep apnea associated with renal failure during CAPD compared with HD. A larger larger study cohort is needed to attest this hypothesis. Acknowledgment: Seed Funding Programme for Basic Research, The University of Hong Kong.