Yi-Che Lee1,2,3, Shih-Yuan Hung1,4, Hao-Kuang Wang5, Chi-Wei Lin6, Hsi-Hao Wang1, Min-Yu Chang1, Ching-Fang Wu1, Junne-Ming Sung7, Yuan-Yow Chiou8, Sheng-Hsiang Lin9,10,11. 1. Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan. 2. School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. 3. Division of Nephrology, Department of Internal Medicine, E-DA Dachang Hospital/I-Shou University, Kaohsiung, Taiwan. 4. School of Medicine for International Students, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan. 5. Department of Neurosurgery, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan. 6. Department of Medical Education, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan. 7. Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. 8. Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan. 9. Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 10. Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan. 11. Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Abstract
STUDY OBJECTIVES: Peritoneal dialysis (PD) is a renal replacement therapy. One concern is whether patients on PD have a higher risk of sleep apnea (SA) due to intra-abdominal pressure increase and worsened ultrafiltration capacity. Despite this concern, to date, whether the risk of SA differs between PD, hemodialysis (HD), and groups without uremia is still uncertain. METHODS: In this retrospective cohort study, data were obtained from the National Health Insurance Research Database of Taiwan. This database enrolled almost all patients on dialysis in the country. A total of 7,645 incident patients on PD and 38,225 incident patients on HD were enrolled. In addition, 38,225 patients without uremia were selected as the comparison cohort. Individuals were monitored for the occurrence of SA until 2013. RESULTS: The results showed that patients on PD, regardless of sex, all had a higher risk of SA than non-dialysis groups. In contrast, the risk of SA in patients on HD was not significantly different from that of patients without uremia. We also compared the risk of SA between patients on PD and HD directly. The results showed that male patients on PD had a significantly higher risk of SA risk than male patients on HD. However, the risk of SA did not differ between female patients on PD and HD. 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.
STUDY OBJECTIVES: Peritoneal dialysis (PD) is a renal replacement therapy. One concern is whether patients on PD have a higher risk of sleep apnea (SA) due to intra-abdominal pressure increase and worsened ultrafiltration capacity. Despite this concern, to date, whether the risk of SA differs between PD, hemodialysis (HD), and groups without uremia is still uncertain. METHODS: In this retrospective cohort study, data were obtained from the National Health Insurance Research Database of Taiwan. This database enrolled almost all patients on dialysis in the country. A total of 7,645 incident patients on PD and 38,225 incident patients on HD were enrolled. In addition, 38,225 patients without uremia were selected as the comparison cohort. Individuals were monitored for the occurrence of SA until 2013. RESULTS: The results showed that patients on PD, regardless of sex, all had a higher risk of SA than non-dialysis groups. In contrast, the risk of SA in patients on HD was not significantly different from that of patients without uremia. We also compared the risk of SA between patients on PD and HD directly. The results showed that male patients on PD had a significantly higher risk of SA risk than male patients on HD. However, the risk of SA did not differ between female patients on PD and HD. 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.
Authors: Jay L Xue; Shu-Cheng Chen; James P Ebben; Edward G Constantini; Susan E Everson; Eric T Frazier; Lawrence Y Agodoa; Allan J Collins Journal: Kidney Int Date: 2002-02 Impact factor: 10.612