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Abstract: PO1115

High-Frequency Oscillations of Intradialytic Arterial Oxygen Saturation in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Tao, Xia, Renal Research Institute, New York, New York, United States
  • Thwin, Ohnmar, Renal Research Institute, New York, New York, United States
  • Preciado, Priscila, Renal Research Institute, New York, New York, United States
  • Cato, Matthew S., Renal Research Institute, New York, New York, United States
  • Thijssen, Stephan, Renal Research Institute, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
Background

High-frequency oscillation of arterial oxygen saturation (SaO2) presenting as repetitive “sawtooth” patterns was observed in sleep apnea patients, but it has never been reported during treatment in hemodialysis (HD) patients. In this study, we explored the prevalence of intradialytic “sawtooth” patterns and their clinical correlates in HD patients.

Methods

We prospectively studied chronic HD patients who didn’t use breathing devices, cardiac pacemaker, nasal oxygen, alpha blockers, short-acting nitrates, or have history of sickle cell anemia and non-sinus cardiac arrhythmia. During two visits per subject, we used the Crit-Line® Monitor to record SaO2 at a frequency of 1 Hz, and video recording to capture periods of wakefulness for the entire treatment. SaO2 data were analyzed for occurrence of “sawtooth” patterns (100% increase in standard deviation lasting ≥10s) and oxygen desaturation episodes (ODE, 3% drop from baseline lasting for ≥10s).

Results

16 subjects studied were 54±11 years old, 63% males, 69% African Americans. SaO2 was 94.3±2.1%. “Sawtooth” patterns covered 19.1% of the recorded treatment time, whereas ODE made up only 0.3%. 9 out of 11 subjects who displayed “sawtooth” patterns, showed them in both visits. “Sawtooth” patterns were more likely to occur during the time when subjects were not awake than during wakefulness (25.3% vs. 17.0% of time in each status). Although ODE were rarely seen, 70% were observed during times when “sawtooth” patterns were also present. Figure 1 shows typical SaO2 “sawtooth” patterns recorded.

Conclusion

Sleep-related breathing disorders are both highly prevalent and underdiagnosed in HD patients and may be underlying the high-frequency oscillations of intradialytic arterial SaO2 observed in this study. These observations might be useful in identifying sleep-related respiratory abnormalities in HD patients that may warrant diagnostic workup. Further studies are needed to identify sleep-related SaO2 oscillations and their relationship to clinical outcomes.

Funding

  • Commercial Support