Kidney Week

Abstract: TH-PO0878

Respiratory Polygraphy Metrics and Intradialytic Blood Pressure Behavior in Patients on Maintenance Hemodiafiltration

Session Information

• Dialysis: Prescription, Physiology, and Treatment Optimization
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Guillermo Durán, Juan Pablo, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Juan Pablo Guillermo Durán, MD

• Zuñiga, Erik Manuel, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Erik Manuel Zuñiga, MD

• Ramirez-Calvillo, Luis Daniel, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Luis Daniel Ramirez-Calvillo, MD, MSc

• Garza Romero, Maria Fernanda, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Maria Fernanda Garza Romero, MD

• Vergara Zavala, Octavio, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Octavio Vergara Zavala, MD

• Robles, Javier, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Javier Robles, MD

• Sanabrais López, María José, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

María José Sanabrais López, MD

• Pinto, Jimena María, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Jimena María Pinto

• Leal Escobar, Gabriela, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Gabriela Leal Escobar, MSc

• Escobar Alvarado, Jennifer Del Carmen, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Jennifer Del Carmen Escobar Alvarado, DrMed

• Rodríguez, Francisco, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Francisco Rodríguez, DrMed

• Lopez-Gil, Salvador, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Salvador Lopez-Gil, MD

Background

Sleep-disordered breathing is highly prevalent among patients receiving maintenance hemodialysis and may contribute to sympathetic overactivity and endothelial dysfunction. We aimed to evaluate the association between respiratory polygraphy metrics and intradialytic blood pressure (BP) behavior in patients undergoing maintenance hemodiafiltration (HDF).

Methods

We performed a cross-sectional study including 29 patients on maintenance HDF who underwent overnight respiratory polygraphy. BP parameters were obtained as averages from 15 HDF sessions. Hypertension in hemodialysis was defined as ≥1 of the following in at least 3 sessions: predialysis BP ≥140/90 mmHg, postdialysis BP ≥130/90 mmHg, or intradialytic hypertension. Obstructive Sleep Apnea (OSA) severity was classified according to apnea-hypopnea index (AHI) as mild (5–14 events/hour), moderate (15–29 events/hour), and severe (≥30 events/hour). Fluid overload was assessed by bioelectrical impedance analysis (BIA) using extracellular water-to-total body water ratio (ECW/TBW).

Results

Hypertension in hemodialysis was present in 14 patients (48.3%) and OSA in 23 (79.3%). Median age was 35 years [31–47], and 58.6% were women. The prevalence of hypertension in hemodialysis did not differ according to OSA presence. Likewise, no significant association was observed between AHI and BP variation. In contrast, nocturnal hypoxemia-related parameters demonstrated more consistent exploratory associations. Oxygen desaturation index positively correlated with maximum intradialytic systolic BP (SBP) (rho=0.21, p=0.29), as did greater maximal desaturation severity (rho=0.20, p=0.29). No significant differences in BIA-assessed fluid overload were observed according to OSA or hypertension in hemodialysis.

Conclusion

Nocturnal hypoxemia burden may better reflect intradialytic hypertensive phenotype than OSA severity alone in maintenance HDF patients.