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sleep apnea esrd

Aviya Lanis, Eric Kerns, Susie L Hu, Margaret H Bublitz, Patricia Risica, Susan Martin, Jeffrey Parker, Richard Millman, Lance D Dworkin, Ghada Bourjeily
PURPOSE: Obstructive sleep apnea is common in patients with end-stage renal disease, and there is increasing evidence that clinical factors specific to end-stage renal disease contribute pathophysiologically to obstructive sleep apnea. It is not known whether circumstances specific to dialysis modality, in this case peritoneal dialysis, affect obstructive sleep apnea. Our study aimed to investigate the prevalence of obstructive sleep apnea in the peritoneal dialysis population and the relevance of dialysis-specific measures and kidney function in assessing this bidirectional relationship...
May 26, 2018: Lung
Sanjiv Mahajan, Kartik Gupta, Sanjeev Sinha, Atul Malhotra, Sandeep Mahajan
BACKGROUND: Sleep-disordered breathing (SDB) is common in patients with end-stage renal disease (ESRD). SDB is associated with comorbidities such as hypertension, diabetes mellitus, and obesity, interplaying with metabolic derangements in the form of uremia, acidosis, and hypervolemia. Renal transplant has been observed to correct most of these metabolic derangements and to control progression of comorbidities. While SDB is highly prevalent among patients in the pretransplant stage, it remains to be seen whether the beneficial aspects of transplant are extended to improvement in SDB in patients with ESRD...
May 2018: Sleep Medicine
Kyoung Sook Park, Jung Hyun Chang, Ea Wha Kang
This report describes the case of a hypertensive 51-year-old male with a 3-year history of peritoneal dialysis. We followed the patient through his diagnosis of severe obstructive sleep apnea (OSA) and treatment with continuous positive airway pressure (CPAP). Therapeutic use of CPAP led to the improvement of not only sleep-related problems, but also cognitive function and quality of life. To our knowledge, this is the first paper describing the benefits of long-term CPAP treatment in an OSA patient undergoing dialysis...
March 2018: Kidney Research and Clinical Practice
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
Matthew Brunner, Enrique Palacios, Harold Neitzschman, Jeremy Mguyen
A 56 year old African-American man presented to the emergency department with dyspnea and dysphagia with drooling. On his initial evaluation, disproportionate obesity of the face, neck and shoulders were noted. The patient's history was significant for obstructive sleep apnea, end-stage renal disease, alcoholic liver disease, pulmonary hypertension and alcoholic cardiomyopathy. He had multi-decade history of heavy alcohol abuse, but quit drinking two years previously.
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles Ferro, Jean-Michel Halimi, Gunnar Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verharr, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease treated with hemodialysis or peritoneal dialysis, hypertension is very common and often poorly controlled. Blood pressure (BP) recordings obtained before or after hemodialysis display a J-shaped or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar hemodynamic setting related with dialysis treatment. Elevated BP by home or ambulatory BP monitoring is clearly associated with shorter survival...
April 2017: Journal of Hypertension
Loheetha Ragupathi, Drew Johnson, Gregary D Marhefka
Surgically created arteriovenous fistulae (AVF) for hemodialysis can contribute to hemodynamic changes. We describe the cases of 2 male patients in whom new right ventricular enlargement developed after an AVF was created for hemodialysis. Patient 1 sustained high-output heart failure solely attributable to the AVF. After AVF banding and subsequent ligation, his heart failure and right ventricular enlargement resolved. In Patient 2, the AVF contributed to new-onset right ventricular enlargement, heart failure, and ascites...
August 2016: Texas Heart Institute Journal
Adrian P Abreo, Lorien S Dalrymple, Glenn M Chertow, George A Kaysen, Charles A Herzog, Kirsten L Johansen
INTRODUCTION: Previous studies of patients with end-stage renal disease have examined the role of fluid shifts on apnea-hypopnea episodes, but the association between volume overload and patient-reported sleep quality or duration has not been well-established. METHODS: We studied the association between predialysis bioimpedance spectroscopy-derived volume estimates and self-reported sleep quality and duration in 638 patients in the United States Renal Data System ACTIVE/ADIPOSE study receiving hemodialysis from 2009 to 2011...
January 2017: Hemodialysis International
Rosilene M Elias, Christopher T Chan, T Douglas Bradley
OBJECTIVE: Although symptoms of sleep disturbances are widely recognized in end-stage renal disease (ESRD), the effect of uremia on sleep structure has not been well investigated. We hypothesized that compared to individuals without ESRD, those with ESRD would have altered sleep structure after controlling for the severity of sleep apnea (SA). METHODS: We studied 57 ESRD patients (42 men) and 57 controls (46 men) who had undergone polysomnography. Control subjects were matched to the ESRD patients by age, body mass index (BMI), frequency of periodic leg movements per hour of sleep, and the frequency of apneas and hypopneas per hour of sleep [apnea-hypopnea index (AHI)]...
April 2016: Sleep Medicine
C Vaughan Tuohy, Maria E Montez-Rath, Mintu Turakhia, Tara I Chang, John W Winkelman, Wolfgang C Winkelmayer
BACKGROUND: Sleep disordered breathing (SDB) such as sleep apnea is associated with cardiovascular disease in the general population. However, little is known about the cardiovascular risks of SDB in patients with end-stage renal disease (ESRD). METHODS: We identified Medicare fee-for-service beneficiaries aged ≥67 years initiating dialysis between 2004 and 2009. Outcomes of interest included all-cause mortality, incident myocardial infarction, ischemic stroke, and atrial fibrillation...
February 9, 2016: BMC Nephrology
Gaurav Nigam, Charu Pathak, Muhammad Riaz
BACKGROUND: Obstructive sleep apnea has been widely studied in patients with chronic renal insufficiency; however only a limited number of studies have reviewed the association between central sleep apnea (CSA) and chronic kidney disease (CKD). The objectives of this systematic review were to assess the prevalence of CSA in and its association with CKD in adult patients and to determine if inclusion of the central hypopnea index affected the reported rates for the prevalence of CSA in CKD...
September 2016: Sleep & Breathing, Schlaf & Atmung
Siraj Omar Wali, Abeer Alkhouli, Mohannad Howladar, Ibrahim Ahmad, Saad Alshohaib, Saeed Al-Ghamdi, Ayman Krayem
AIM: The prevalence of obstructive sleep apnea (OSA) in end-stage renal disease (ESRD) patients was reported to be 10-fold that in the general population. OSA can worsen the clinical symptoms and cardiovascular complications of ESRD. We aimed to investigate the prevalence of symptoms and risk of OSA among Saudi patients with ESRD. SETTINGS AND DESIGN: This multi-center, cross-sectional study was conducted in Jeddah, Saudi Arabia, between June 2012 and September 2013...
October 2015: Annals of Thoracic Medicine
Afsoon Emami Naini, Babak Amra, Leila Mahmoodnia, Shahram Taheri
BACKGROUND: This study was aimed to evaluate the prevalence of obstructive sleep apnea (OSA) and restless legs syndrome (RLS) in patients with end-stage renal disease (ESRD) after kidney transplantation. MATERIALS AND METHODS: Two hundred kidney transplant recipients were enrolled in this cross-sectional study. Data on age, gender, etiology of ESRD, history of previous kidney transplantation, serum creatinine, and the presence or absence of OSA and RLS were collected...
2015: Advanced Biomedical Research
Owen D Lyons, T Douglas Bradley, Christopher T Chan
In end-stage renal disease (ESRD) and heart failure, conditions characterized by fluid overload, both obstructive sleep apnea (OSA) and central sleep apnea (CSA) are highly prevalent. This observation suggests that fluid overload may be a unifying mechanism in the pathogenesis of both OSA and CSA in these conditions. An overnight rostral fluid shift from the legs to the neck and lungs has been shown to contribute to the pathogenesis of OSA and CSA, respectively, in various different patient populations. This article reviews the evidence that supports a role for fluid overload and overnight fluid shift in the pathogenesis of sleep apnea in ESRD...
July 2015: Seminars in Nephrology
Sushma M Dharia, Mark L Unruh, Lee K Brown
Sleep is an essential function of life and serves a crucial role in the promotion of health and performance. Poor sleep quality and sleep disorders have been a recurrent finding in patients with chronic kidney disease (CKD). Sleep disorders such as obstructive sleep apnea (OSA) can contribute to hypertension, diabetes, cardiovascular disease, and worsen obesity, all of which are implicated in the etiology of CKD, but CKD itself may lead to OSA. Relationships between CKD/end-stage renal disease (ESRD) and OSA have been the subject of numerous investigations, but central sleep apnea (CSA) also is highly prevalent in CKD/ESRD but remains poorly understood, underdiagnosed, and undertreated in these patients...
July 2015: Seminars in Nephrology
Jae-Kwan Song
Infective endocarditis (IE) has been increasingly diagnosed in patients without previously detected predisposing heart disease, but its clinical features have yet to be fully determined. A recent single-center study including echocardiographic images and surgical findings investigated the incidence of undiagnosed, clinically silent valvular or congenital heart diseases and healthcare-associated infective endocarditis (HAIE). The study confirmed that a large proportion of patients with IE have no previous history of heart disease...
July 2015: Korean Journal of Internal Medicine
Yehuda Handelsman, Zachary T Bloomgarden, George Grunberger, Guillermo Umpierrez, Robert S Zimmerman, Timothy S Bailey, Lawrence Blonde, George A Bray, A Jay Cohen, Samuel Dagogo-Jack, Jaime A Davidson, Daniel Einhorn, Om P Ganda, Alan J Garber, W Timothy Garvey, Robert R Henry, Irl B Hirsch, Edward S Horton, Daniel L Hurley, Paul S Jellinger, Lois Jovanovič, Harold E Lebovitz, Derek LeRoith, Philip Levy, Janet B McGill, Jeffrey I Mechanick, Jorge H Mestman, Etie S Moghissi, Eric A Orzeck, Rachel Pessah-Pollack, Paul D Rosenblit, Aaron I Vinik, Kathleen Wyne, Farhad Zangeneh
UNLABELLED: The American Association of Clinical Endocrinologists/American College of Endocrinology Medical Guidelines for Clinical Practice are systematically developed statements to assist healthcare professionals in medical decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication...
April 2015: Endocrine Practice
Abhishek Dubey, Surya Kant, Sunita Tiwari, Sarita Agarwal, Abbas Ali Mahdi
BACKGROUND: Leptin takes part in regulation of energy balance, neuronal functions, pain and mood. It may act as intermediary marker for various components of HRQOL in patients of obstructive sleep apnea syndrome. AIMS: To document the correlation among leptin levels, obesity and HRQoL in OSAS patients. METHODS: A tertiary care hospital based cross-sectional study was done in 224 subjects aged 18-65 years, after taking informed consent. Subjects with previous history of smoking, Liver disease, COPD, CHD, T2 DM, asthma, cancer, end stage renal disease, heart failure, any endocrine disorder including Cushing syndrome, thyroid, on systemic steroid or any continuous medication for last 6 months, on dieting or suffering from any disability condition (other than obesity and OSAS) affecting their HRQoL were excluded from the study...
April 2015: Indian Journal of Tuberculosis
G Mancia, F Mahfoud, K Narkiewicz, L M Ruilope, M P Schlaich, R E Schmieder, B Williams, M Böhm
OBJECTIVE: The Global SYMPLICITY Registry (GSR) provides real world experience regarding the effects of radiofrequency denervation of the renal artery nerves in patients with uncontrolled hypertension. These data in hypertensive patients with a high proportion of concomitant conditions also characterized by sympathetic nervous system will further characterize the effects of renal denervation across a diverse patient population. DESIGN AND METHOD: The GSR is a prospective, open-label, registry being conducted at 245 international sites...
June 2015: Journal of Hypertension
Haitham Ezzat, Amr Mohab
Sleep disorders are common among the patients undergoing dialysis in end stage renal disease (ESRD). Although variable, their prevalence has been reported to be higher when compared to the general population. The most frequently reported complaints are insomnia, restless leg syndrome (RLS), sleep-disordered breathing and excessive daytime sleepiness (EDS). The aim of this study was to assess the prevalence of sleep disorders in end stage renal disease patients on regular hemodialysis (group I with 30 patients) and CKD patients (group II with 30 patients) in comparison to 30 normal population (control group)...
July 2015: Renal Failure
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