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Kidney Week

Abstract: PUB165

Surveillance of Patients on Dialysis in a Large Polysomnography Database in Okinawa, Japan

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Author

  • Iseki, Kunitoshi, Nakamura Clinic, Urasoe, Okinawa, Japan
Background

Sleep disturbance is a major cause of lowering quality of life (QOL) and may contribute to high mortality rate of chronic dialysis patients. Overnight polysomnography (PSG) is the precise method to diagnose sleep disturbance such as obstructive sleep apnea (OSA). However, there is a few reports on characteristics of OSA among dialysis patients based on PSG database.

Methods

Since September 1990, we have a large PSG database: the Okinawa Nakamura Clinic Sleep (ONSLEEP) registry (Nakamura K, et al. J Clin Sleep Med 2021). By reviewing medical records, we surveyed hemodialysis (HD) patients by the end of March, 2024. Baseline data at the first PSG such as age, body mass index (BMI), and apnea hypopnea index (AHI) were obtained. Also, we collected dialysis-related date such as the start date of chronic dialysis therapy and primary cause of end-stage renal disease. To compare those not-on dialysis, we used data of the previous report (N=6,483).

Results

There were 374 dialysis patients (men 302, women 72). The median (interquartile range, IQR) age, BMI and AHI at PSG were 57.0 (49.0-67.0) years, 27.2 (23.6-30.8) kg/m2and 32.3 (13.9-66.4) per hour. PSG was performed before starting dialysis in 204 patients (54.5%). Demographics at the PSG were compared between after and before starting dialysis therapy (Table 1). Those who tested PSG before starting dialysis were significantly higher BMI and AHI.

Conclusion

Results support the notion that continuous positive airway pressure (CPAP) therapy may lowered the death risk, and they survived until start dialysis therapy. Whether the use of CPAP is effective to retard the progression of CKD remained to be studied.

Baseline characteristics at the time of PSG. Data are presented as median (IQR) for continuous measures, and n (%) for categorical measures.