title: The effect of fluid overload on sleep apnoea severity in haemodialysis patients.
abstract: As in heart failure, obstructive and central sleep apnoea (OSA and CSA, respectively) are common in end-stage renal disease. Fluid overload characterises end-stage renal disease and heart failure, and in heart failure plays a role in the pathogenesis of OSA and CSA. We postulated that in end-stage renal disease patients, those with sleep apnoea would have greater fluid volume overload than those without.End-stage renal disease patients on thrice-weekly haemodialysis underwent overnight polysomnography on a nondialysis day to determine their apnoea-hypopnoea index (AHI). Extracellular fluid volume of the total body, neck, thorax and right leg were measured using bioelectrical impedance.28 patients had an AHI ≥15 (sleep apnoea group; OSA:CSA 21:7) and 12 had an AHI <15 (no sleep apnoea group). Total body extracellular fluid volume was 2.6 L greater in the sleep apnoea group than in the no sleep apnoea group (p=0.006). Neck, thorax, and leg fluid volumes were also greater in the sleep apnoea than the no sleep apnoea group (p<0.05), despite no difference in body mass index (p=0.165).These findings support a role for fluid overload in the pathogenesis of both OSA and CSA in end-stage renal disease.
authors.affiliation: Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada.|Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada.|Dept of Medicine, Women's College Hospital, Toronto, ON, Canada.
authors.forename: Owen D
authors.initials: OD
authors.lastname: Lyons
authors.affiliation: Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada.|Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada.
authors.forename: Toru
authors.initials: T
authors.lastname: Inami
authors.affiliation: Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada.|Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada.
authors.forename: Elisa
authors.initials: E
authors.lastname: Perger
authors.affiliation: Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Yadollahi
authors.affiliation: Dept of Medicine, University Health Network Toronto General Hospital, Toronto, ON, Canada.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Chan
authors.affiliation: Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada douglas.bradley@utoronto.ca.|Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada.|Dept of Medicine, University Health Network Toronto General Hospital, Toronto, ON, Canada.
authors.forename: T Douglas
authors.initials: TD
authors.lastname: Bradley
mesh_terms: D000328:Adult; D015992:Body Mass Index; D017097:Electric Impedance; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D006435:Renal Dialysis; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*