Kidney Week

Abstract: FR-PO753

Screening for Obstructive Sleep Apnea in Hemodialysis Patients Using the Crit-Line Monitor

Session Information

• Dialysis: Inflammation and Infection
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Thwin, Ohnmar, Renal Research Institute, New York, New York, United States

Ohnmar Thwin,

• Tao, Xia, Renal Research Institute, New York, New York, United States

Xia Tao,

• Tapia, Mirell, Renal Research Institute, New York, New York, United States

Mirell Tapia,

• Preciado, Priscila, Renal Research Institute, New York, New York, United States

Priscila Preciado,

• Thijssen, Stephan, Renal Research Institute, New York, New York, United States

Stephan Thijssen,

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko,

Background

Obstructive sleep apnea (OSA) is common among end-stage renal disease patients.The absence of airflow leads to a decrease in arterial and peripheral blood oxygen saturation (SO₂). A saw-tooth pattern of SO₂ is considered as a sign of OSA. The Crit-Line monitor (CLM) is being used in hemodialysis (HD) centers.Our goal was to investigate if CLM can be used to identify sleep-related breathing disorders

Methods

Prosprective, observational study done in chronic HD patients. Subjects were studied twice and equipped with a WatchPAT device (FDA approved device for OSA) and videotaped and CLM data was recorded. The degree of simililarity between SO₂ from WatchPAT and CLM was determined by cross-correlation analysis

Results

We studied 14 patients (age 55.4±10 yrs, 64% males, BMI 25.6±6.8 kg/m²) with a total of 27 visits. We identified a saw-tooth pattern in the SO₂ signals in 9 sessions (Fig 1). The cross-correlation coefficient between CLM and WatchPAT for SO₂ was 0.93±0.11 for 9 visits. Prolonged desaturation (>3% points from baseline) episodes occurred in 5 visits, with 4 showing SO₂ saw-tooth patterns. Fig.2 shows the SO₂ signals from CLM and WatchPAT for one of these visits. Cross-correlation coefficient is 0.89±0.10 for these 5 visits, and 0.53±0.23 for visits without saw-tooth pattern

Conclusion

While there was a high degree of correlation between the SO₂ from the CLM and the WatchPAT device, the CLM captures a higher-resolution. CLM provides richer information and reveals SO₂ nuances (such as the signature SO₂ saw-tooth patterns) better than the WatchPAT device.It is ought to be possible to use the CLM for screening for sleep apnea as well as other blood oxygenation disorders. Further validation is required (e.g. comparison to polysomnography)