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Abstract: FR-PO409

Association of Functional Outcomes of Sleep and Intermediary Cardiovascular Outcomes in Incident Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kerns, Eric S., Lahey Clinic, Burlington, Massachusetts, United States
  • Fitzpatrick, Jessica, The Hospital for Sick Children, Toronto, Ontario, Canada
  • Sozio, Stephen M., Johns Hopkins University, Baltimore, Maryland, United States
  • Jaar, Bernard G., Johns Hopkins University, Baltimore, Maryland, United States
  • Estrella, Michelle M., UCSF/San Francisco VA Medical Center, San Francisco, California, United States
  • Monroy-Trujillo, Jose Manuel, Johns Hopkins University, Baltimore, Maryland, United States
  • Parekh, Rulan S., The Hospital For Sick Children, Toronto, Ontario, Canada
  • Bourjeily, Ghada, Miriam Hospital/Brown University, Providence, Rhode Island, United States
Background

Prior studies show that sleep conditions are associated with an increased risk of cardiovascular (CV) disease and mortality in adults initiating hemodialysis (HD). It is not known whether functional outcomes of sleep (fatigue, concentration difficulty, and memory impairment) are associated with CV morbidity in incident HD patients. We sought to examine whether functional outcomes of poor sleep were associated with intermediary cardiovascular outcomes in incident HD.

Methods

In 228 incident hemodialysis patients from the Predictors of Arrhythmic and Cardiovascular risk in ESRD (PACE) study, Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10), a validated questionnaire that assesses the functional effect of daytime sleepiness through 5 domains (general productivity, activity level, social outcomes, vigilance and intimacy and sexual relationship), was administered within 6 months of enrollment. Baseline comorbidities, including history of CV disease and diabetes, were ascertained by chart review, and baseline cardiac testing, including ECG and echocardiogram, was obtained. Intermediary cardiovascular outcomes included (QTc [ms], heart rate variability [ms2], left ventricular mass index [g/m2, LVMI], and left ventricular hypertrophy [LVH]). Associations of log transformed FOSQ-10 scores with intermediary outcomes were examined using linear regression.

Results

Mean age was 55 years, median body mass index was 28 (IQR 24,33), median Charlson comorbidity index was 5 (IQR 4,6), with 68% African American. Lower FOSQ-10 scores, indicating greater impairment from sleep disturbances, were associated with greater QTc duration and lower heart rate variability after adjustment for clinical factors.[Table] There were no significant associations of FOSQ-10 score and LVMI or LVH.

Conclusion

In adults initiating hemodialysis, poor functional outcomes of sleep are associated with increased risk of intermediary CV outcomes. Screening for sleep disturbances in incident hemodialysis patients may identify individuals at increased risk for adverse CV outcomes.

Funding

  • NIDDK Support