Effect of Ultrafiltration on Sleep Apnea and Cardiac Function in End-Stage Renal Disease.

Effect of Ultrafiltration on Sleep Apnea and Cardiac Function in End-Stage Renal Disease. Am J Nephrol. 2020 Jan 14;:1-8 Authors: Inami T, Lyons OD, Perger E, Yadollahi A, Floras JS, Chan CT, Bradley TD Abstract RATIONALE: End-stage renal disease (ESRD) patients have high annual mortality mainly due to cardiovascular causes. The acute effects of obstructive and central sleep apnea on cardiac function in ESRD patients have not been determined. We therefore tested, in patients with ESRD, the hypotheses that (1) sleep apnea induces deterioration in cardiac function overnight and (2) attenuation of sleep apnea severity by ultrafiltration (UF) attenuates this deterioration. METHODS: At baseline, ESRD patients, on conventional hemodialysis, with left ventricular ejection fraction (LVEF)>45% had polysomnography (PSG) performed on a non-dialysis day to determine the apnea-hypopnea index (AHI). Echocardiography was performed at the bedside, before and after sleep. Isovolumetric contraction time divided by left ventricular ejection time (IVCT/ET) and isovolumetric relaxation time divided by ET (IVRT/ET) were measured by tissue doppler imaging. The myocardial performance index (MPI), a composite of systolic and diastolic function was also calculated. One week later, subjects with sleep apnea (AHI ≥15) had fluid removed by UF, followed by repeat PSG and echocardiography. -Results: Fifteen subjects had baseline measurements, of which 7 had an AHI
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: Am J Nephrol Source Type: research

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Background: Sleep disordered breathing (SDB) is prevalent in patients with chronic kidney disease (CKD) in particular those with end-stage renal disease (ESRD). Fluid overload plays a key role in the pathogenesis of obstructive and central sleep apnea (OSA and CSA) in ESRD. We hypothesized that in patients with ESRD, removal of water or uremic substances by hemodialysis would reduce SDB.Methods: We conducted sleep studies for 7 consecutive days using the SD-101 (Kentzmedico Co. Ltd, Saitama, Japan), which is a novel, non-restrictive, a sheet-type device of SA screening for 9 ESRD patients undergoing maintenance hemodialysi...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
sti R Abstract Protein carbonylation is a marker of oxidative protein damage, that is likely involved in the pathogenesis of several diseases. The aim of this study was to evaluate the protein carbonyl (PC) groups in different clinical conditions. It included different groups of subjects: 81 trained subjects; 23 subjects with mild essential hypertension; 31 middle-aged subjects with metabolic syndrome (MS); 106 subjects with MS not selected for age (subdivided into two subgroups, with and without diabetes mellitus); 91 obese adults subdivided in two subgroups (BMI 30-35 Kg/m2 and BMI > 35 kg/m2); 48 subject...
Source: Clinical Hemorheology and Microcirculation - Category: Hematology Authors: Tags: Clin Hemorheol Microcirc Source Type: research
Conclusions:Patients on PD should receive regular SA assessments and that an increased awareness and a higher index of suspicion for SA should be maintained in these patients, especially male patients.Citation:Lee YC, Hung SY, Wang HK, Lin CW, Wang HH, Chang MY, Wu CF, Sung JM, Chiou YY, Lin SH. Male patients on peritoneal dialysis have a higher risk of sleep apnea.J Clin Sleep Med. 2019;15(7):937–945.
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
CONCLUSIONSurgical procedures for weight reduction in dialysis patients does not independently increase the risk for adverse outcomes after bariatric surgery. The estimation of DW through BIA is an effective method for avoiding complications generated by excessive or deficient ultrafiltration.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
-Chieh Chou Our study aimed to determine the incidence and severity of obstructive sleep apnea (OSA) in patients with end-stage renal disease (ESRD) and also whether different dialysis modalities confer different risk and treatment response for OSA. We used Taiwan’s National Health Insurance Research Database for analysis and identified 29,561 incident dialysis patients as the study cohort between 2000 and 2011. Each dialysis patient was matched with four non-dialysis control cases by age, sex, and index date. Cox regression hazard models were used to identify the risk of OSA. The incidence rate of OSA was hi...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Introduction: Restless leg syndrome (RLS) is a sensorimotor condition with symptoms comprising of an urge to move the legs which is usually but not always accompanied by uncomfortable and unpleasant sensations in the legs. The restlessness occurs or worsens at rest, in the evening or night than during the day and is relieved by activity. Sleep disorders such as sleep apnea, restless legs syndrome and periodic limb movement are frequent in chronic kidney disease (CKD). Among them, restless legs syndrome may affect up to 4.5% of patients not on dialysis and 20.3% in patients on hemodialysis.
Source: Sleep Medicine - Category: Sleep Medicine Authors: Tags: Restless Legs Syndrome (RLS) Source Type: research
[Image from unsplash.com]From Acera Surgical and Telos Medical’s partnership to Xtant Medical’s 510(k) clearance, here are seven medtech stories we missed this week but thought were still worth a mention. 1. Acera Surgical partners with Telos Medical for Restrata wound matrix trial Telos Partners announced in a Sept. 14 press release that Acera Surgical has chosen Telos to lead its Restrata wound matrix study. The study will surgery the clinical outcomes of Restrata treatments for diabetic foot ulcers and test for effectiveness and safety. Restrata is a fully synthetic wound matrix that is FDA-cleared for ...
Source: Mass Device - Category: Medical Devices Authors: Tags: 510(k) Business/Financial News Clinical Trials Dental Diagnostics Food & Drug Administration (FDA) Regulatory/Compliance Surgical Acera Surgical Contego Medical Fresenius MedTech OBP Medical Pinnacle Sciences Plusoptix Telos Source Type: news
In patients with end-stage renal disease treated with hemodialysis or peritoneal dialysis, hypertension is very common and often poorly controlled. Blood pressure (BP) recordings obtained before or after hemodialysis display a J-shaped or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar hemodynamic setting related with dialysis treatment. Elevated BP by home or ambulatory BP monitoring is clearly associated with shorter survival. Sodium and volume excess is the prominent mechanism of hypertension in dialysis patients, but oth...
Source: Journal of Hypertension - Category: Cardiology Tags: Consensus Document Source Type: research
Patients receiving hemodialysis complain frequently about sleep disorder. In order to assess the sleep disorder in these patients, we conducted in collaboration with the Nephrology Service Ibn Rochd CHU, a survey using Morpheus Network questionnaire, which covered 90 patients receiving the dialysis stage. The questionnaires have been collected over one year period between 2013 and 2014. Out of the 90 patients, 49% have sleep disorder, in which women predominated . The total population's average age was 70 year old. The average time between the start of the dialysis and the sleep disorder onset is 11 years. The reported sle...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 4.2 Sleep and Control of Breathing Source Type: research
Abstract RATIONALE: In end stage renal disease (ESRD), a condition characterized by fluid overload, both obstructive and central sleep apnea (OSA and CSA, respectively) are common. This observation suggests that fluid overload is involved in the pathogenesis of both OSA and CSA in this condition. OBJECTIVE: To test the hypothesis that fluid removal by ultrafiltration (UF) will reduce severity of both OSA and CSA in patients with ESRD. METHODS: At baseline, on a non-dialysis day, ESRD patients on thrice-weekly hemodialysis underwent overnight polysomnography (PSG) along with measurement of total body extr...
Source: American Journal of Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Am J Respir Crit Care Med Source Type: research
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