CIN '2007 - 4o CONGRESSO DE NEFROLOGIA NA INTERNET
Sleep apnoea in End Stage Renal Disease; Impact on mortality and the potential role of CPAP
Dr Indranil Chakravorty
Visiting Fellow, Beds & Herts Postgraduate Medical School, University of Hertfordshire, College Lane, Hatfield, Herts
Abstract
Patients with End Stage Renal Disease (ESRD) on renal replacement therapy have a high prevalence of disorders of mood, sleepi and experience poor health related quality of life (HRQL)ii and a high mortalityiii. Sleep disorders appear even in the early stages of chronic kidney disease. These disturbances are complex, including difficulties in falling asleep and awakening, interrupted sleep, nightmares, restless legs syndrome (RLS), and Periodic limb movement disorder (PLMS) and sleep apnoea (SA). Major etiological factors of sleep disorders in the uremic patients include older age, long dialysis, alcohol and tobacco abuse and, particularly, the presence of significant comorbidities. The usual contributors to this high mortality are concurrent diseases which include Diabetes mellitus, hypertension, hypercholesterolaemia and coronary artery diseaseiv. Sleep apnoea is an independent risk factor associated with hypertension, heart disease and poor quality of life in the general population. While the prevalence of SA in general population is 2-4%, the prevalence reported in ESRD patients may be up to 50%. Hence the concurrent presence of SA in ESRD patients may pose a substantial additional risk.Comments: