Mochida Yasuhiro, Ohtake Takayasu, Ishioka Kunihiro, Oka Machiko, Maesato Kyoko, Moriya Hidekazu, Hidaka Sumi, Kobayashi Shuzo
Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, Kanagawa, Japan.
J Clin Med. 2023 Jan 20;12(3):858. doi: 10.3390/jcm12030858.
It is unclear whether the severity of sleep-disordered breathing (SDB) affects the risk of cardiovascular events and mortality in patients undergoing hemodialysis (HD). We determined the severity of SDB with the 3% oxygen desaturation index (ODI) via overnight pulse oximetry. This study was a retrospective cohort, observational study of 134 patients on maintenance HD at a single center. They were divided into four groups according to SDB severity (normal, mild, moderate, and severe), and were followed. The baseline characteristics of all patients were as follows: the median age was 67 (interquartile range, 59-75) years, 64.2% were men, 37.3% were diabetic, and the median duration of HD was 69 (29-132) months. During follow-up, major adverse cardiovascular events (MACEs) occurred in 71 patients and deaths in 60 (including 32 cardiovascular deaths). Severe SDB was an independent risk factor for MACEs (hazard ratio [HR] = 4.66, 95% confidence interval [CI] = 1.87-11.61, = 0.001) and all-cause death (HR = 5.74, 95% CI = 1.92-16.70, = 0.001). Severe SDB had a statistically significant impact on the risk of MACEs and mortality in patients undergoing HD. The severity of the 3% ODI via overnight pulse oximetry may be a useful marker as a risk factor for cardiovascular outcomes and mortality in these patients.
睡眠呼吸障碍（SDB）的严重程度是否会影响接受血液透析（HD）患者发生心血管事件和死亡的风险尚不清楚。我们通过夜间脉搏血氧饱和度测定法，以3%氧饱和度下降指数（ODI）来确定SDB的严重程度。本研究是一项针对单中心134例维持性HD患者的回顾性队列观察研究。根据SDB严重程度（正常、轻度、中度和重度）将他们分为四组，并进行随访。所有患者的基线特征如下：年龄中位数为67（四分位间距，59 - 75）岁，男性占64.2%，糖尿病患者占37.3%，HD持续时间中位数为69（29 - 132）个月。随访期间，71例患者发生了主要不良心血管事件（MACE），60例患者死亡（包括32例心血管死亡）。严重SDB是MACE（风险比[HR]=4.66，95%置信区间[CI]=1.87 - 11.61，P = 0.001）和全因死亡（HR = 5.74，95% CI = 1.92 - 16.70，P = 0.001）的独立危险因素。严重SDB对接受HD患者发生MACE和死亡的风险有统计学显著影响。通过夜间脉搏血氧饱和度测定法得出的3% ODI严重程度，可能是这些患者心血管结局和死亡风险的一个有用标志物。
