Lyons Owen D, Bradley T Douglas, Chan Christopher T
Sleep Research Laboratory of the University Health Network Toronto Rehabilitation Institute, Toronto, Ontario, Canada; Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, Ontario, Canada.
Sleep Research Laboratory of the University Health Network Toronto Rehabilitation Institute, Toronto, Ontario, Canada; Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, Ontario, Canada; Division of Respirology, University of Toronto, Toronto, Ontario, Canada.
Semin Nephrol. 2015 Jul;35(4):373-82. doi: 10.1016/j.semnephrol.2015.06.008.
In end-stage renal disease (ESRD) and heart failure, conditions characterized by fluid overload, both obstructive sleep apnea (OSA) and central sleep apnea (CSA) are highly prevalent. This observation suggests that fluid overload may be a unifying mechanism in the pathogenesis of both OSA and CSA in these conditions. An overnight rostral fluid shift from the legs to the neck and lungs has been shown to contribute to the pathogenesis of OSA and CSA, respectively, in various different patient populations. This article reviews the evidence that supports a role for fluid overload and overnight fluid shift in the pathogenesis of sleep apnea in ESRD. The diagnosis, epidemiology, and clinical features of sleep apnea in patients with ESRD also are considered.
在以液体超负荷为特征的终末期肾病（ESRD）和心力衰竭中，阻塞性睡眠呼吸暂停（OSA）和中枢性睡眠呼吸暂停（CSA）都极为常见。这一观察结果表明，液体超负荷可能是这些情况下OSA和CSA发病机制中的一个统一机制。在不同患者群体中，夜间从腿部到颈部和肺部的头向液体转移已分别被证明有助于OSA和CSA的发病机制。本文综述了支持液体超负荷和夜间液体转移在ESRD睡眠呼吸暂停发病机制中作用的证据。还考虑了ESRD患者睡眠呼吸暂停的诊断、流行病学和临床特征。
