Prevalence and Diagnostic Approach to Sleep Apnea in Hemodialysis Patients: A Population Study.
Background. Previous observations found a high prevalence of obstructive sleep apnea (OSA) in the hemodialysis population, but the best diagnostic approach remains undefined. We assessed OSA prevalence and performance of available screening tools to propose a specific diagnostic algorithm. Methods....
| Publicado en: | BioMed Research International Vol. 2015; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
7/1/2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109274697&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109274697 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 23146133 FT2T jtl: BioMed Research International issn: 23146133 maglogo: N pubinfo: dt: 7/1/2015 vid: 2015 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 109274697 109274697 109274697 10.1155/2015/103686 109274697 ppf: 1 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Prevalence and Diagnostic Approach to Sleep Apnea in Hemodialysis Patients: A Population Study. aug: au: Forni Ogna, Valentina Ogna, Adam Pruijm, Menno Bassi, Isabelle Zuercher, Emilie Halabi, Georges Phan, Olivier Bullani, Roberto Teta, Daniel Gauthier, Thierry Cherpillod, Anne Mathieu, Claudine Mihalache, Alexandra Cornette, Francoise Haba-Rubio, José Burnier, Michel Heinzer, Raphaël affil: Department of Nephrology and Hypertension, University Hospital of Lausanne (CHUV), 1011 Lausanne, Switzerland sug: subj: Sleep Apnea Syndromes Epidemiology Sleep Apnea Syndromes Diagnosis Dialysis Patients Human Funding Source Switzerland Prevalence ROC Curve Clinical Assessment Tools Questionnaires Body Composition Data Analysis Software T-Tests Chi Square Test Wilcoxon Rank Sum Test Logistic Regression Models, Statistical Goodness of Fit Chi Square Test Male Female Middle Age Aged Aged, 80 and Over Descriptive Statistics Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background. Previous observations found a high prevalence of obstructive sleep apnea (OSA) in the hemodialysis population, but the best diagnostic approach remains undefined. We assessed OSA prevalence and performance of available screening tools to propose a specific diagnostic algorithm. Methods. 104 patients from 6 Swiss hemodialysis centers underwent polygraphy and completed 3 OSA screening scores: STOP-BANG, Berlin’s Questionnaire, and Adjusted Neck Circumference. The OSA predictors were identified on a derivation population and used to develop the diagnostic algorithm, which was validated on an independent population. Results. We found 56% OSA prevalence (AHI ≥ 15/h), which was largely underdiagnosed. Screening scores showed poor performance for OSA screening (ROC areas 0.538 [SE 0.093] to 0.655 [SE 0.083]). Age, neck circumference, and time on renal replacement therapy were the best predictors of OSA and were used to develop a screening algorithm, with higher discriminatory performance than classical screening tools (ROC area 0.831 [0.066]). Conclusions. Our study confirms the high OSA prevalence and highlights the low diagnosis rate of this treatable cardiovascular risk factor in the hemodialysis population. Considering the poor performance of OSA screening tools, we propose and validate a specific algorithm to identify hemodialysis patients at risk for OSA for whom further sleep investigations should be considered. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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