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Kidney Week

Abstract: TH-PO230

Fluid Overload and Obstructive Sleep Apnea in Hemodiafiltration

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Nava, Marcos Garcia, Instituto Nacional de Cardiologia, Ciudad de Mexico, Mexico
  • Escobar alvarado, Jennifer Del carmen, Instituto Nacional de Cardiologia, Ciudad de Mexico, Mexico
  • Leal, Gabriela, Instituto Nacional de Cardiologia, Ciudad de Mexico, Mexico
  • Grovas, Hector Perez, Instituto Nacional de Cardiologia, Ciudad de Mexico, Mexico
  • Castellanos, Francisco eugenio Rodriguez, Instituto Nacional de Cardiologia, Ciudad de Mexico, Mexico
  • Sandoval zarate, Julio, Instituto Nacional de Cardiologia, Ciudad de Mexico, Mexico
  • Madero, Magdalena, Instituto Nacional de Cardiologia, Ciudad de Mexico, Mexico
Background

Obstructive sleep apnea (OSA) seems to be more common in patients with end-stage renal disease (ESRD) than in the general population with a prevalence as high as 50 to 70%.Fluid overload leading to greater accumulation in the neck when supine may contribute to increased upper airway collapsibility. The aim of the study was to evaluate the impact of ultrafiltration on the apnea-hypopnoea index (AHI) in prevalent hemodiafiltration (HDF) patients.

Methods

We included patients from the HDF unit at the Instituto Nacional de Cardiologia from July 2018 to April 2019. Bioimpedance and overnight polysomnography were done the day before and the day after HDF. The primary outcome was AHI index. T test was used for within group comparisons (pre and post HDF) and Rho Spearman was used for correlations.

Results

16 patients were included, 10 had mild AHI, 3 moderate AHI and 3 had severe AHI. After HDF, 11 patients improved the number of apnea/hyponea events . Patients with severe AHI significantly improved after HDF (38±6.4 to 25.2±9.4, p=0.03). Total body water/ extracellular relationship (TBW/ECW), thoracic TBW/ECW, scale and dry weight were all significantly associated with AHI improvement. There was a significant correlation between AHI and post HDF weight scale and dry weight (r = 0.56, p = 0.022 and r= 0-59, p = 0.016 respectively)(Figure).

Conclusion

AHI is improved with HDF, in particular in those with moderate and severe OSA. Volume overload appears to contribute to OSA in this population.