Background: It is known that Sleep apnea syndrome (SAS) adversely effects the incidence of cardiovascular disease. However, the influence of SAS in hemodialysis patients is not fully understood.
Purpose: We investigated the influence of hypoxia in hemodialysis patients.
Methods: 45 dialysis patients (39 men) who had been examined using polysomnography (PSG) and had an apnea hypopnea index >20, and a further 45 sleep apnea syndrome patients (38 men) who suffered from daytime sleepiness or frequent nighttime urination and had an apnea hypopnea index >20. We investigated the correlation between the parameters of PSG and carotid arterial ultrasonography, heart ultrasonography and arterial stiffness using the Cardio-Ankle Vascular Index (CAVI) on the same day. CAVI was measured using the VaSera VS-1500 machine (Fukuda Denshi).
Results: In the comparison of the 2 groups, there was no significant change in arterial age, 60.6 (12.2) in dialysis patients versus 63.3 (14.5) in non-dialysis patients. The weight and Body Mass Index (BMI) were significantly lower in dialysis patients.70.9 (17.3) kg versus 79.9 (24.5) kg, p<0.05. 25.4 (5.2) versus 28.6 (6.2), p<0.01. There were significantly more cases of diabetes and coronary artery disease in dialysis patients. The ejection fraction (EF) was significantly lower in dialysis patients. 56.2 (18.3) % versus 66.1 (8.7) %, p<0.01. Max intima media thickness (IMT) was significantly higher in dialysis patients on both sides. 1.8 (0.9) mm versus 1.4 (0.6) mm in the right carotid artery, p<0.01. 2.0 (0.8) mm versus 1.4 (0.8) mm in the left carotid artery, p<0.01. CAVI was significantly higher in dialysis patients. 9.3 (1.9) versus 8.5 (1.4), p<0.05. There was a negative correlation between EF and the lowest SpO2 values by PSG in dialysis patients. (r=-0.324 and p<0.05). There was a negative correlation between EF and apnea duration by PSG in non-dialysis patients. (r=-0.390 and p<0.05).
Conclusions: we need to consider the effect of SAS on dialysis patients.