Kidney Week

Abstract: TH-PO1130

Narrow Upper Airway Due to Fluid Overload Affects Severity of Asymptomatic Sleep Apnea Syndrome in ESRD

Session Information

• Fluid, Electrolyte, Acid-Base Disorders
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Fluid, Electrolytes, and Acid-Base

• 704 Fluid, Electrolyte, Acid-Base Disorders

Authors

• Kano, Toshiki, Juntendo University Faculty of Medicine, Tokyo, Japan

Toshiki Kano,

• Suzuki, Hitoshi, Juntendo University Faculty of Medicine, Tokyo, Japan

Hitoshi Suzuki,

• Shioda, Ryotaro, Juntendo University Faculty of Medicine, Tokyo, Japan

Ryotaro Shioda,

• Suzuki, Yusuke, Juntendo University Faculty of Medicine, Tokyo, Japan

Yusuke Suzuki,

Background

Sleep apnea syndrome (SAS) has been reported in 50% of patients with end-stage renal disease (ESRD). It is hypothesized that SAS in ESRD patients is caused by narrow upper airway due to fluid overload. SAS is considered as an independent risk factor for hypertension, congestive heart failure, acute coronary syndrome, pulmonary hypertension, arrhythmia and cerebrovascular event. The aim of present study is to clarify involvement of SAS in ESRD patients and to evaluate the association between severity of SAS and body fluid condition in ESRD patients.

Methods

The apnea-hypopnea index (AHI) and its severity were measured in twenty-five patients with ESRD using a portable sleep monitoring device. Body weight (BW), cardio thoracic ratio (CTR), serum levels of BNP, AHI were measured during the therapeutic course of hemodialysis. The association of AHI with age, gender, body mass index (BMI), history of smoking and complication of ESRD were analyzed.

Results

In twenty-five patients with ESRD, 96.0 % patients were diagnosed as asymptomatic SAS. Those ESRD patients with SAS were divided according to AHI scores into mild (AHI 5-14.9, 20.8%), moderate (AHI 15-29.9, 29.2%) and severe SAS (AHI ≥30, 50.0%) groups. Patients with hypoalbuminemia showed severe SAS (P<0.05). Moreover, there was a trend that patients with diabetes showed severe SAS. Asymptomatic SAS was improved by treatment of fluid overload (P<0.01). Changes of AHI by intervention of fluid overload was associated with decrease of BNP (P<0.05) and CTR (P<0.05).

Conclusion

Asymptomatic SAS is a major complication in patients with ESRD. Present findings suggested that fluid overload induced edema of upper airway resulted in asymptomatic SAS. Diagnosis and appropriate management of SAS is important to improve the mortality of ESRD patients.