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Article: Alleviation of sleep apnea in patients with chronic renal failure by nocturnal cycler-assisted peritoneal dialysis compared with conventional continuous ambulatory peritoneal dialysis

TitleAlleviation of sleep apnea in patients with chronic renal failure by nocturnal cycler-assisted peritoneal dialysis compared with conventional continuous ambulatory peritoneal dialysis
Authors
Issue Date2006
PublisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.org
Citation
Journal Of The American Society Of Nephrology, 2006, v. 17 n. 9, p. 2607-2616 How to Cite?
AbstractNocturnal hemodialysis has been shown to improve sleep apnea in patients who receive conventional hemodialysis. It was hypothesized that nocturnal peritoneal dialysis (NPD) also is effective in correcting sleep apnea in patients who receive continuous ambulatory PD (CAPD). Overnight polysomnography (PSG) was performed in 46 stable NPD and CAPD patients who were matched for demographic and clinical attributes. The prevalence of sleep apnea, defined as an apnea-hypopnea index (AHI; or frequency of apnea and hypopnea per hour of sleep) ≥15, was 52% for NPD patients and 91% for CAPD patients (P = 0.007). The mean (±SD) AHI in NPD and CAPD patients was 31.6 ± 25.6 and 50.9 ± 26.4 (P = 0.025), respectively. For validation of the efficacy of NPD in alleviating sleep apnea, a fixed sequence intervention study was performed in which 24 incident PD patients underwent one PSG study during mandatory cycler-assisted NPD while awaiting their turn for CAPD training and a second PSG recording shortly after they were established on stable CAPD. The prevalence of sleep apnea was 4.2% during NPD and 33.3% during CAPD (P = 0.016). AHI increased from 3.4 ± 1.34 during NPD to 14.0 ± 3.46 during CAPD (P < 0.001). With the use of bioelectrical impedance analysis, total body water content was significantly lower during stable NPD than CAPD (32.8 ± 7.37 versus 35.1 ± 7.35 L; P = 0.004). NPD delivered greater reductions in total body water (-2.81 ± 0.45 versus -1.34 ± 0.3 L; P = 0.015) and hydration fraction (-3.63 ± 0.64 versus -0.71 ± 0.52%; P = 0.005) during sleep. Pulmonary function tests remained unchanged before and after conversion from NPD to CAPD. These findings suggest that NPD may have a therapeutic edge over CAPD in sleep apnea that is associated with renal failure as a result of better fluid clearance during sleep. Copyright © 2006 by the American Society of Nephrology.
Persistent Identifierhttp://hdl.handle.net/10722/77807
ISSN
2015 Impact Factor: 8.491
2015 SCImago Journal Rankings: 4.699
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTang, SCWen_HK
dc.contributor.authorLam, Ben_HK
dc.contributor.authorKu, PPen_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.accessioned2010-09-06T07:35:57Z-
dc.date.available2010-09-06T07:35:57Z-
dc.date.issued2006en_HK
dc.identifier.citationJournal Of The American Society Of Nephrology, 2006, v. 17 n. 9, p. 2607-2616en_HK
dc.identifier.issn1046-6673en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77807-
dc.description.abstractNocturnal hemodialysis has been shown to improve sleep apnea in patients who receive conventional hemodialysis. It was hypothesized that nocturnal peritoneal dialysis (NPD) also is effective in correcting sleep apnea in patients who receive continuous ambulatory PD (CAPD). Overnight polysomnography (PSG) was performed in 46 stable NPD and CAPD patients who were matched for demographic and clinical attributes. The prevalence of sleep apnea, defined as an apnea-hypopnea index (AHI; or frequency of apnea and hypopnea per hour of sleep) ≥15, was 52% for NPD patients and 91% for CAPD patients (P = 0.007). The mean (±SD) AHI in NPD and CAPD patients was 31.6 ± 25.6 and 50.9 ± 26.4 (P = 0.025), respectively. For validation of the efficacy of NPD in alleviating sleep apnea, a fixed sequence intervention study was performed in which 24 incident PD patients underwent one PSG study during mandatory cycler-assisted NPD while awaiting their turn for CAPD training and a second PSG recording shortly after they were established on stable CAPD. The prevalence of sleep apnea was 4.2% during NPD and 33.3% during CAPD (P = 0.016). AHI increased from 3.4 ± 1.34 during NPD to 14.0 ± 3.46 during CAPD (P < 0.001). With the use of bioelectrical impedance analysis, total body water content was significantly lower during stable NPD than CAPD (32.8 ± 7.37 versus 35.1 ± 7.35 L; P = 0.004). NPD delivered greater reductions in total body water (-2.81 ± 0.45 versus -1.34 ± 0.3 L; P = 0.015) and hydration fraction (-3.63 ± 0.64 versus -0.71 ± 0.52%; P = 0.005) during sleep. Pulmonary function tests remained unchanged before and after conversion from NPD to CAPD. These findings suggest that NPD may have a therapeutic edge over CAPD in sleep apnea that is associated with renal failure as a result of better fluid clearance during sleep. Copyright © 2006 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.jasn.orgen_HK
dc.relation.ispartofJournal of the American Society of Nephrologyen_HK
dc.subject.meshAdulten_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshKidney Failure, Chronic - complications - therapyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPeritoneal Dialysis - methodsen_HK
dc.subject.meshPeritoneal Dialysis, Continuous Ambulatoryen_HK
dc.subject.meshPolysomnographyen_HK
dc.subject.meshPrevalenceen_HK
dc.subject.meshSleep Apnea Syndromes - complications - epidemiology - therapyen_HK
dc.titleAlleviation of sleep apnea in patients with chronic renal failure by nocturnal cycler-assisted peritoneal dialysis compared with conventional continuous ambulatory peritoneal dialysisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1046-6673&volume=17&spage=2607&epage=2616&date=2006&atitle=Alleviation+of+sleep+apnea+in+patients+with+chronic+renal+failure+by+nocturnal+cycler-assisted+peritoneal+dialysis+compared+with+conventional+continuous+ambulatory+peritoneal+dialysisen_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.doi10.1681/ASN.2005090936en_HK
dc.identifier.pmid16885414en_HK
dc.identifier.scopuseid_2-s2.0-33748042629en_HK
dc.identifier.hkuros132131en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33748042629&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume17en_HK
dc.identifier.issue9en_HK
dc.identifier.spage2607en_HK
dc.identifier.epage2616en_HK
dc.identifier.isiWOS:000240113400032-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTang, SCW=7403437082en_HK
dc.identifier.scopusauthoridLam, B=9246012800en_HK
dc.identifier.scopusauthoridKu, PP=49761681500en_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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