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Volume 15 No. 07
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Accepted Papers





Scientific Investigations

Male Patients on Peritoneal Dialysis Have a Higher Risk of Sleep Apnea

Yi-Che Lee, MD, PhD1,2,3; Shih-Yuan Hung, MD1,4; Hao-Kuang Wang, MD, PhD5; Chi-Wei Lin, MD, MS6; Hsi-Hao Wang, MD, MS1; Min-Yu Chang, MD, MS1; Ching-Fang Wu, MD, PhD1; Junne-Ming Sung, MD, PhD7; Yuan-Yow Chiou, MD, PhD8; Sheng-Hsiang Lin, PhD9,10,11
1Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan; 2School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan; 3Division of Nephrology, Department of Internal Medicine, E-DA Dachang Hospital/I-Shou University, Kaohsiung, Taiwan; 4School of Medicine for International Students, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan; 5Department of Neurosurgery, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan; 6Department of Medical Education, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan; 7Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; 8Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan; 9Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 10Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan; 11Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Study Objectives:

Peritoneal dialysis (PD) is a renal replacement therapy. One concern is whether patients on PD have a higher risk of sleep apnea (SA) due to intra-abdominal pressure increase and worsened ultrafiltration capacity. Despite this concern, to date, whether the risk of SA differs between PD, hemodialysis (HD), and groups without uremia is still uncertain.

Methods:

In this retrospective cohort study, data were obtained from the National Health Insurance Research Database of Taiwan. This database enrolled almost all patients on dialysis in the country. A total of 7,645 incident patients on PD and 38,225 incident patients on HD were enrolled. In addition, 38,225 patients without uremia were selected as the comparison cohort. Individuals were monitored for the occurrence of SA until 2013.

Results:

The results showed that patients on PD, regardless of sex, all had a higher risk of SA than non-dialysis groups. In contrast, the risk of SA in patients on HD was not significantly different from that of patients without uremia. We also compared the risk of SA between patients on PD and HD directly. The results showed that male patients on PD had a significantly higher risk of SA risk than male patients on HD. However, the risk of SA did not differ between female patients on PD and HD.

Conclusions:

Patients on PD should receive regular SA assessments and that an increased awareness and a higher index of suspicion for SA should be maintained in these patients, especially male patients.

Citation:

Lee YC, Hung SY, Wang HK, Lin CW, Wang HH, Chang MY, Wu CF, Sung JM, Chiou YY, Lin SH. Male patients on peritoneal dialysis have a higher risk of sleep apnea. J Clin Sleep Med. 2019;15(7):937–945.


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