title: Relationship among end-stage renal disease, hypertension, and sleep apnea in nondiabetic dialysis patients.
abstract: BACKGROUND
  Cardiovascular diseases (CVD) are responsible for more than 50% of the deaths in patients with end-stage renal disease (ESRD). Sleep apnea (SA) has been recognized as a risk factor for CVD. Previous studies have shown a higher prevalence of SA among patients on dialysis.
  
  
  METHODS
  Forty-five nondiabetics patients with ESRD underwent a polysomnographic analysis with concomitant clinical evaluation and laboratory tests. Fourteen patients (31.1%) presented with an apnea/hypopnea index (AHI) more than 5, confirming a high prevalence of SA. We observed abnormal sleep pattern with high percentages of sleep stage 1 and low percentages of sleep stages 3 and 4.
  
  
  RESULTS
  Patients with AHI more than 5 presented higher levels of systolic, diastolic, and mean blood pressures (MBP) as compared with those with AHI less than 5 (P < .05). When other variables were compared (age, time of dialytic treatment, cause of ESRD, use of antihypertensive drugs, body mass index, serum levels of hemoglobin, hematocrit, creatinine, KT/V index, pH, bicarbonate, parathormone, and alkaline phosphatase), no differences were found between the two groups. In a logistic regression model, MBP and age more than 40 years were positively related to the presence of SA.
  
  
  CONCLUSIONS
  Our study is in agreement with previous works and shows that patients with ESRD have a higher SA index compared to those with normal renal function. In spite of having higher levels of BP no other parameter was different among apneic and nonapneic patients. Hypertension may play a pivotal role linking SA and CVD.
authors.affiliation: cjorodrigues@uol.com.br
authors.forename: Cassio José
authors.initials: CJ
authors.lastname: de Oliveira Rodrigues
authors.forename: Odair
authors.initials: O
authors.lastname: Marson
authors.forename: Sérgio
authors.initials: S
authors.lastname: Tufic
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Kohlmann
authors.forename: Sonia Maria
authors.initials: SM
authors.lastname: Guimarães
authors.forename: Pereira
authors.initials: P
authors.lastname: Togeiro
authors.forename: Artur Beltrame
authors.initials: AB
authors.lastname: Ribeiro
authors.forename: Agostinho
authors.initials: A
authors.lastname: Tavares
mesh_terms: D000328:Adult; D000375:Aging; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D006435:Renal Dialysis; D016037:Single-Blind Method; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology