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Article: Improvement in sleep apnea during nocturnal peritoneal dialysis is associated with reduced airway congestion and better uremic clearance

TitleImprovement in sleep apnea during nocturnal peritoneal dialysis is associated with reduced airway congestion and better uremic clearance
Authors
Issue Date2009
PublisherAmerican Society of Nephrology. The Journal's web site is located at http://www.cjasn.org
Citation
Clinical Journal Of The American Society Of Nephrology, 2009, v. 4 n. 2, p. 410-418 How to Cite?
AbstractBackground and objectives: Among peritoneal dialysis (PD) patients, nocturnal PD (NPD) is known to improve sleep apnea compared with continuous ambulatory peritoneal dialysis (CAPD), but the contributing factors are unclear. Design, setting, participants, and measurements: Thirty-eight incident ESRD patients underwent overnight polysomnography (PSG) during NPD and CAPD. Bioelectrical impedance analysis, magnetic resonance imaging of the upper airway, and urea kinetics (Kt/V) during sleep were measured on both occasions. Results: The prevalence of severe sleep apnea (apnea-hypopnea index, AHI ≥ 15/h) was 21.1% during NPD, and 42.1% during CAPD. Mean AHI increased from 9.6 ± 2.7/h during NPD to 21.5 ± 4.2/h during CAPD. Both obstructive and central apnea worsened after conversion to CAPD. NPD achieved greater reductions in total body water, hydration fraction, and net ultrafiltration than CAPD during sleep. Overnight peritoneal Kt/V and creatinine clearance were lower after conversion. Both peritoneal Kt/V and peritoneal creatinine clearance correlated with AHI, as did their changes after conversion. Volumetric magnetic resonance imaging revealed reduced pharyngeal volumes and cross-sectional area, and tongue enlargement after conversion. Conclusions: Improvement in sleep apnea during NPD versus CAPD is associated with better fluid and uremic clearance and reduced upper airway congestion during sleep. Copyright © 2009 by the American Society of Nephrology.
Persistent Identifierhttp://hdl.handle.net/10722/58632
ISSN
2015 Impact Factor: 4.657
2015 SCImago Journal Rankings: 2.534
PubMed Central ID
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. The authors are grateful to Agnes Lai and Barbara Law (Sleep Laboratory), Sandra Luen (Division of Nephrology), Helena Leung and all nursing staff (K18N Dialysis Unit) for coordinating the PSG and MRI studies; Jack Lain (Sleep Laboratory) for scoring all PSGs manually; Kan Ming Lo (Sleep Laboratory) for performing all BIA measurements; and Suki Ho (Dialysis Unit) for performing all Urea kinetics Computation.

References

 

DC FieldValueLanguage
dc.contributor.authorTang, SCWen_HK
dc.contributor.authorLam, Ben_HK
dc.contributor.authorLai, ASHen_HK
dc.contributor.authorPang, CBYen_HK
dc.contributor.authorTso, WKen_HK
dc.contributor.authorKhong, PLen_HK
dc.contributor.authorIp, MSMen_HK
dc.contributor.authorLai, KNen_HK
dc.date.accessioned2010-05-31T03:34:00Z-
dc.date.available2010-05-31T03:34:00Z-
dc.date.issued2009en_HK
dc.identifier.citationClinical Journal Of The American Society Of Nephrology, 2009, v. 4 n. 2, p. 410-418en_HK
dc.identifier.issn1555-9041en_HK
dc.identifier.urihttp://hdl.handle.net/10722/58632-
dc.description.abstractBackground and objectives: Among peritoneal dialysis (PD) patients, nocturnal PD (NPD) is known to improve sleep apnea compared with continuous ambulatory peritoneal dialysis (CAPD), but the contributing factors are unclear. Design, setting, participants, and measurements: Thirty-eight incident ESRD patients underwent overnight polysomnography (PSG) during NPD and CAPD. Bioelectrical impedance analysis, magnetic resonance imaging of the upper airway, and urea kinetics (Kt/V) during sleep were measured on both occasions. Results: The prevalence of severe sleep apnea (apnea-hypopnea index, AHI ≥ 15/h) was 21.1% during NPD, and 42.1% during CAPD. Mean AHI increased from 9.6 ± 2.7/h during NPD to 21.5 ± 4.2/h during CAPD. Both obstructive and central apnea worsened after conversion to CAPD. NPD achieved greater reductions in total body water, hydration fraction, and net ultrafiltration than CAPD during sleep. Overnight peritoneal Kt/V and creatinine clearance were lower after conversion. Both peritoneal Kt/V and peritoneal creatinine clearance correlated with AHI, as did their changes after conversion. Volumetric magnetic resonance imaging revealed reduced pharyngeal volumes and cross-sectional area, and tongue enlargement after conversion. Conclusions: Improvement in sleep apnea during NPD versus CAPD is associated with better fluid and uremic clearance and reduced upper airway congestion during sleep. Copyright © 2009 by the American Society of Nephrology.en_HK
dc.languageengen_HK
dc.publisherAmerican Society of Nephrology. The Journal's web site is located at http://www.cjasn.orgen_HK
dc.relation.ispartofClinical Journal of the American Society of Nephrologyen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshCircadian Rhythmen_HK
dc.subject.meshCreatinine - metabolismen_HK
dc.subject.meshCross-Over Studiesen_HK
dc.subject.meshElectric Impedanceen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshKidney Failure, Chronic - complications - metabolism - pathology - therapyen_HK
dc.subject.meshKineticsen_HK
dc.subject.meshMagnetic Resonance Imagingen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPeritoneal Dialysis - adverse effects - methodsen_HK
dc.subject.meshPeritoneal Dialysis, Continuous Ambulatory - adverse effectsen_HK
dc.subject.meshPolysomnographyen_HK
dc.subject.meshRespiratory System - pathologyen_HK
dc.subject.meshSeverity of Illness Indexen_HK
dc.subject.meshSleep Apnea Syndromes - etiology - prevention & controlen_HK
dc.subject.meshUrea - metabolismen_HK
dc.subject.meshUremia - etiology - metabolism - pathology - therapyen_HK
dc.titleImprovement in sleep apnea during nocturnal peritoneal dialysis is associated with reduced airway congestion and better uremic clearanceen_HK
dc.typeArticleen_HK
dc.identifier.emailTang, SCW: scwtang@hku.hken_HK
dc.identifier.emailKhong, PL: plkhong@hkucc.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.authorityKhong, PL=rp00467en_HK
dc.identifier.authorityIp, MSM=rp00347en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.2215/CJN.03520708en_HK
dc.identifier.pmid19118118-
dc.identifier.pmcidPMC2637593-
dc.identifier.scopuseid_2-s2.0-66849131377en_HK
dc.identifier.hkuros155353en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-66849131377&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume4en_HK
dc.identifier.issue2en_HK
dc.identifier.spage410en_HK
dc.identifier.epage418en_HK
dc.identifier.isiWOS:000263372800023-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTang, SCW=7403437082en_HK
dc.identifier.scopusauthoridLam, B=9246012800en_HK
dc.identifier.scopusauthoridLai, ASH=8711668800en_HK
dc.identifier.scopusauthoridPang, CBY=25641666400en_HK
dc.identifier.scopusauthoridTso, WK=7006905486en_HK
dc.identifier.scopusauthoridKhong, PL=7006693233en_HK
dc.identifier.scopusauthoridIp, MSM=7102423259en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK

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