Haemodialysis patients with sleep apnoea syndrome experience increased central adiposity and altered muscular composition and functionality
Background. Sleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may affect functional capacity and quality of life in haemodialysis patients. We tested the hypothesis that apneic dialysis patients due to the la...
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| Published in | Nephrology, dialysis, transplantation Vol. 23; no. 1; pp. 336 - 344 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford
Oxford University Press
01.01.2008
Oxford Publishing Limited (England) |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Background. Sleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may affect functional capacity and quality of life in haemodialysis patients. We tested the hypothesis that apneic dialysis patients due to the lack of restorative sleep will have a further reduced functional capacity and further compromised quality of life compared to their non-apneic counterparts. Methods. Forty-three clinically stable haemodialysis patients (13 F, 56.6 ± 19.4 years) were examined. After polysomnographic analysis, patients were divided in two groups according to their calculated apnoea hypopnoea index (AHI; cutoff 5). Primary outcomes were intergroup differences in the following: (1) physical capacity and muscle performance, assessed by functional tests, (2) quality of life, assessed by the SF-36, (3) body composition, measured by DEXA and (4) muscle composition and size, as well as (5) visceral (VAT) and subcutaneous (SAT) adipose tissue, calculated by computed tomography. Results. Twenty-two patients had AHI >5 (4 F, AHI = 28.8 ± 22.3). The adjusted analysis for age, BMI and years in dialysis therapy, showed that the low-AHI group (N = 21, 9 F, AHI = 1.8 ± 1.3) had better functional capacity, and performed better in muscle strength and endurance tests compared to the high-AHI group. There were no differences in lean body mass and % total body fat between groups, however, values for VAT, VAT/TAT ratio and thigh muscles’ fat infiltration were increased in the high-AHI group. VAT correlated with BMI (r = 0.682, P = 0.001), functional capacity (r = 0.558, P = 0.001) apnoea hypopnoea index (r = 0.530, P = 0.001). There were no statistical significant differences in quality of life between the two groups. To further account for age and BMI differences, a subgroup of patients was matched by age, sex and BMI (N = 10/group). In the matched analysis, all the above statistical differences remained, between the low-AHI and high-AHI groups. Conclusions. Haemodialysis patients with sleep apnoea syndrome demonstrate poorer functional capacity, physical performance and muscle composition, compared to non-apneic dialysis patients. Overall, sleep apnoea appears to partly contribute to the total diminished functional capacity of haemodialysis patients. |
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| AbstractList | Sleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may affect functional capacity and quality of life in haemodialysis patients. We tested the hypothesis that apneic dialysis patients due to the lack of restorative sleep will have a further reduced functional capacity and further compromised quality of life compared to their non-apneic counterparts.
Forty-three clinically stable haemodialysis patients (13 F, 56.6+/-19.4 years) were examined. After polysomnographic analysis, patients were divided in two groups according to their calculated apnoea hypopnoea index (AHI; cutoff 5). Primary outcomes were intergroup differences in the following: (1) physical capacity and muscle performance, assessed by functional tests, (2) quality of life, assessed by the SF-36, (3) body composition, measured by DEXA and (4) muscle composition and size, as well as (5) visceral (VAT) and subcutaneous (SAT) adipose tissue, calculated by computed tomography.
Twenty-two patients had AHI >5 (4 F, AHI=28.8+/-22.3). The adjusted analysis for age, BMI and years in dialysis therapy, showed that the low-AHI group (N=21, 9 F, AHI=1.8+/-1.3) had better functional capacity, and performed better in muscle strength and endurance tests compared to the high-AHI group. There were no differences in lean body mass and % total body fat between groups, however, values for VAT, VAT/TAT ratio and thigh muscles' fat infiltration were increased in the high-AHI group. VAT correlated with BMI (r=0.682, P=0.001), functional capacity (r=0.558, P=0.001) apnoea hypopnoea index (r=0.530, P=0.001). There were no statistical significant differences in quality of life between the two groups. To further account for age and BMI differences, a subgroup of patients was matched by age, sex and BMI (N=10/group). In the matched analysis, all the above statistical differences remained, between the low-AHI and high-AHI groups.
Haemodialysis patients with sleep apnoea syndrome demonstrate poorer functional capacity, physical performance and muscle composition, compared to non-apneic dialysis patients. Overall, sleep apnoea appears to partly contribute to the total diminished functional capacity of haemodialysis patients. Background. Sleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may affect functional capacity and quality of life in haemodialysis patients. We tested the hypothesis that apneic dialysis patients due to the lack of restorative sleep will have a further reduced functional capacity and further compromised quality of life compared to their non-apneic counterparts. Methods. Forty-three clinically stable haemodialysis patients (13 F, 56.6 ± 19.4 years) were examined. After polysomnographic analysis, patients were divided in two groups according to their calculated apnoea hypopnoea index (AHI; cutoff 5). Primary outcomes were intergroup differences in the following: (1) physical capacity and muscle performance, assessed by functional tests, (2) quality of life, assessed by the SF-36, (3) body composition, measured by DEXA and (4) muscle composition and size, as well as (5) visceral (VAT) and subcutaneous (SAT) adipose tissue, calculated by computed tomography. Results. Twenty-two patients had AHI >5 (4 F, AHI = 28.8 ± 22.3). The adjusted analysis for age, BMI and years in dialysis therapy, showed that the low-AHI group (N = 21, 9 F, AHI = 1.8 ± 1.3) had better functional capacity, and performed better in muscle strength and endurance tests compared to the high-AHI group. There were no differences in lean body mass and % total body fat between groups, however, values for VAT, VAT/TAT ratio and thigh muscles' fat infiltration were increased in the high-AHI group. VAT correlated with BMI (r = 0.682, P = 0.001), functional capacity (r = 0.558, P = 0.001) apnoea hypopnoea index (r = 0.530, P = 0.001). There were no statistical significant differences in quality of life between the two groups. To further account for age and BMI differences, a subgroup of patients was matched by age, sex and BMI (N = 10/group). In the matched analysis, all the above statistical differences remained, between the low-AHI and high-AHI groups. Conclusions. Haemodialysis patients with sleep apnoea syndrome demonstrate poorer functional capacity, physical performance and muscle composition, compared to non-apneic dialysis patients. Overall, sleep apnoea appears to partly contribute to the total diminished functional capacity of haemodialysis patients. BACKGROUNDSleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may affect functional capacity and quality of life in haemodialysis patients. We tested the hypothesis that apneic dialysis patients due to the lack of restorative sleep will have a further reduced functional capacity and further compromised quality of life compared to their non-apneic counterparts.METHODSForty-three clinically stable haemodialysis patients (13 F, 56.6+/-19.4 years) were examined. After polysomnographic analysis, patients were divided in two groups according to their calculated apnoea hypopnoea index (AHI; cutoff 5). Primary outcomes were intergroup differences in the following: (1) physical capacity and muscle performance, assessed by functional tests, (2) quality of life, assessed by the SF-36, (3) body composition, measured by DEXA and (4) muscle composition and size, as well as (5) visceral (VAT) and subcutaneous (SAT) adipose tissue, calculated by computed tomography.RESULTSTwenty-two patients had AHI >5 (4 F, AHI=28.8+/-22.3). The adjusted analysis for age, BMI and years in dialysis therapy, showed that the low-AHI group (N=21, 9 F, AHI=1.8+/-1.3) had better functional capacity, and performed better in muscle strength and endurance tests compared to the high-AHI group. There were no differences in lean body mass and % total body fat between groups, however, values for VAT, VAT/TAT ratio and thigh muscles' fat infiltration were increased in the high-AHI group. VAT correlated with BMI (r=0.682, P=0.001), functional capacity (r=0.558, P=0.001) apnoea hypopnoea index (r=0.530, P=0.001). There were no statistical significant differences in quality of life between the two groups. To further account for age and BMI differences, a subgroup of patients was matched by age, sex and BMI (N=10/group). In the matched analysis, all the above statistical differences remained, between the low-AHI and high-AHI groups.CONCLUSIONSHaemodialysis patients with sleep apnoea syndrome demonstrate poorer functional capacity, physical performance and muscle composition, compared to non-apneic dialysis patients. Overall, sleep apnoea appears to partly contribute to the total diminished functional capacity of haemodialysis patients. Background. Sleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may affect functional capacity and quality of life in haemodialysis patients. We tested the hypothesis that apneic dialysis patients due to the lack of restorative sleep will have a further reduced functional capacity and further compromised quality of life compared to their non-apneic counterparts. Methods. Forty-three clinically stable haemodialysis patients (13 F, 56.6 ± 19.4 years) were examined. After polysomnographic analysis, patients were divided in two groups according to their calculated apnoea hypopnoea index (AHI; cutoff 5). Primary outcomes were intergroup differences in the following: (1) physical capacity and muscle performance, assessed by functional tests, (2) quality of life, assessed by the SF-36, (3) body composition, measured by DEXA and (4) muscle composition and size, as well as (5) visceral (VAT) and subcutaneous (SAT) adipose tissue, calculated by computed tomography. Results. Twenty-two patients had AHI >5 (4 F, AHI = 28.8 ± 22.3). The adjusted analysis for age, BMI and years in dialysis therapy, showed that the low-AHI group (N = 21, 9 F, AHI = 1.8 ± 1.3) had better functional capacity, and performed better in muscle strength and endurance tests compared to the high-AHI group. There were no differences in lean body mass and % total body fat between groups, however, values for VAT, VAT/TAT ratio and thigh muscles' fat infiltration were increased in the high-AHI group. VAT correlated with BMI (r = 0.682, P = 0.001), functional capacity (r = 0.558, P = 0.001) apnoea hypopnoea index (r = 0.530, P = 0.001). There were no statistical significant differences in quality of life between the two groups. To further account for age and BMI differences, a subgroup of patients was matched by age, sex and BMI (N = 10/group). In the matched analysis, all the above statistical differences remained, between the low-AHI and high-AHI groups. Conclusions. Haemodialysis patients with sleep apnoea syndrome demonstrate poorer functional capacity, physical performance and muscle composition, compared to non-apneic dialysis patients. Overall, sleep apnoea appears to partly contribute to the total diminished functional capacity of haemodialysis patients. |
| Author | Stefanidis, Ioannis Dovas, Spiros Lavdas, Eleftherios Fezoulidis, Ioannis Gourgoulianis, Konstantinos I. Pastaka, Chaido Hadjigeorgiou, Georgios M. Sakkas, Giorgos K. Maridaki, Maria D. Soher, Brian J. Karatzaferi, Christina Liakopoulos, Vassilios |
| Author_xml | – sequence: 1 givenname: Giorgos K. surname: Sakkas fullname: Sakkas, Giorgos K. email: gsakkas@med.uth.gr organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 2 givenname: Konstantinos I. surname: Gourgoulianis fullname: Gourgoulianis, Konstantinos I. organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 3 givenname: Christina surname: Karatzaferi fullname: Karatzaferi, Christina organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 4 givenname: Vassilios surname: Liakopoulos fullname: Liakopoulos, Vassilios organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 5 givenname: Maria D. surname: Maridaki fullname: Maridaki, Maria D. organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 6 givenname: Chaido surname: Pastaka fullname: Pastaka, Chaido organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 7 givenname: Eleftherios surname: Lavdas fullname: Lavdas, Eleftherios organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 8 givenname: Brian J. surname: Soher fullname: Soher, Brian J. organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 9 givenname: Spiros surname: Dovas fullname: Dovas, Spiros organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 10 givenname: Ioannis surname: Fezoulidis fullname: Fezoulidis, Ioannis organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 11 givenname: Georgios M. surname: Hadjigeorgiou fullname: Hadjigeorgiou, Georgios M. organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA – sequence: 12 givenname: Ioannis surname: Stefanidis fullname: Stefanidis, Ioannis organization: Department of Nephrology, Department of Respiratory Medicine, Department of Radiology, Department of Neurology, School of Medicine, University of Thessaly, Greece, Department of Sport Science University of Athens, Greece, Institute for Human Performance and Rehabilitation CERETETH, Trikala, Institute of Biomedical Research and Technology, CERETETH, Larissa, Department of Sport Science University of Thessaly, Greece, Department of Radiology, Dukes University, USA and Department of Medicine, Division of Endocrinology, University of California, San Francisco, USA |
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| Keywords | haemodialysis muscle functional capacity fat infiltration obstructive sleep apnoea-hypopnoea syndrome lean body mass (LBM) visceral adipose tissue Kidney disease Human Urinary system disease Adipose tissue Hemodialysis Functional capacity Extrarenal dialysis Sleep Renal failure Lean body mass Infiltration |
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| Snippet | Background. Sleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may... Sleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may affect... BACKGROUNDSleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may... |
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| SubjectTerms | Abdominal Fat Adolescent Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cross-Sectional Studies Emergency and intensive care: renal failure. Dialysis management fat infiltration Female Glomerulonephritis haemodialysis Humans Intensive care medicine lean body mass (LBM) Male Medical sciences Middle Aged muscle functional capacity Muscle, Skeletal - physiopathology Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure obstructive sleep apnoea–hypopnoea syndrome Renal Dialysis - adverse effects Sleep Apnea Syndromes - etiology Sleep Apnea Syndromes - pathology Sleep Apnea Syndromes - physiopathology visceral adipose tissue |
| Title | Haemodialysis patients with sleep apnoea syndrome experience increased central adiposity and altered muscular composition and functionality |
| URI | https://api.istex.fr/ark:/67375/HXZ-JHVW9BHF-4/fulltext.pdf https://www.ncbi.nlm.nih.gov/pubmed/17890750 https://www.proquest.com/docview/218152320/abstract/ https://search.proquest.com/docview/70202119 |
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