Department of Internal Medicine, Medical Research Institute, Alexandria University, Alexandria, Egypt.
Sleep Breath. 2013 May;17(2):621-8. doi: 10.1007/s11325-012-0732-0. Epub 2012 Jun 9.
We assessed the prevalence of sleep disordered breathing (SDB) and investigated its effects on the muscle functional capacity and quality of life (QoL) among chronic kidney disease (CKD) Egyptian patients, either maintained or not maintained on hemodialysis (HD).
The study population comprised 100 CKD patients who were divided into patients maintained on HD (n = 60; M/F = 28:32) and patients not maintained on HD (n = 40; M/F = 24:16). Patients were observed overnight using the pulse-oximetry technique and further subdivided into patients with SDB and patients without SDB, according to their calculated oxygen desaturation index (cutoff 5). All patients were subjected also to estimation of Kt/V ratio (which is a measure for the efficiency of HD), body-composition analysis, biochemical analysis, muscle functional capacity, and QoL measurements using standard methods and questionnaires, respectively.
Primary outcomes were intergroup differences regarding physical capacity and muscle performance, QoL, and body-composition measurements. CKD patients in general, either maintained on HD or not, suffer from SDB, and the levels of urea and creatinine may increase the incidence of SDB in CKD patients not maintained on HD. CKD patients maintained on HD with SDB had poorer functional capacity, physical performance, and muscle composition, in comparison with those without SDB.
Overall, SDB appears to partly contribute to the total diminished functional capacity of HD patients. Thus, CKD patients maintained on HD with SDB had significantly lower sleep quality and QoL as compared to those not maintained on HD with or without SDB.
我们评估了睡眠呼吸障碍(SDB)的流行率,并研究了其对埃及慢性肾脏病(CKD)患者肌肉功能能力和生活质量(QoL)的影响,这些患者要么接受血液透析(HD)维持治疗,要么未接受 HD 维持治疗。
研究人群包括 100 名 CKD 患者,他们分为接受 HD 维持治疗的患者(n=60;男/女=28:32)和未接受 HD 维持治疗的患者(n=40;男/女=24:16)。患者使用脉搏血氧测定技术过夜观察,并根据其计算出的氧减饱和指数(截断值为 5)进一步分为 SDB 患者和非 SDB 患者。所有患者还接受了 Kt/V 比值(衡量 HD 效率的指标)、身体成分分析、生化分析、肌肉功能能力和 QoL 测量,分别采用标准方法和问卷。
主要结局是物理能力和肌肉表现、QoL 和身体成分测量方面的组间差异。一般来说,接受 HD 维持治疗或不接受 HD 维持治疗的 CKD 患者都患有 SDB,而尿素和肌酐水平可能会增加未接受 HD 维持治疗的 CKD 患者中 SDB 的发生率。患有 SDB 的接受 HD 维持治疗的 CKD 患者的功能能力、身体表现和肌肉成分较差,与无 SDB 的患者相比。
总的来说,SDB 似乎部分导致了 HD 患者整体功能能力的下降。因此,患有 SDB 的接受 HD 维持治疗的 CKD 患者的睡眠质量和 QoL 明显低于未接受 HD 维持治疗的患者,无论他们是否患有 SDB。