Trastornos del sueño en pacientes en hemodiálisis: Estudio polisomnográfico con grupo control

Objetives: To evaluate the quality of the sleep and sleep disorders breathing in patients with chronic kidney disease stage 4-5 (CKD4-5) and in hemodialysis respect healthy population. In addition, to study in these last ones, the prevalence of the obstructive sleep apnea-hypoapnea syndrome (SAHS) and the existence of some analytical marker associated to SAHS. Patients and methods: There were studied 32 patients with CKD in hemodialysis (24 men and 8 women, age of 54±16, BMI of 25±3.9), 14 patients with CKD 4-5 and a group of 14 healthy subjects; these groups were matched for age, gender, and BMI with the hemodialysis group. All of them were studied with a clinical history and a overnight polisomnography. We stablished the diagnostic of SAHS when the apnea-hypoapnea index (AHI) ?10. Results: Patients with CKD 4-5 showed worse quality of sleep and more episodes of AHI respect healthy control group, although without statistic signification. The group in hemodialysis had less quantity and worse quality of sleep than the control group with an AHI significatly higher (4.3 ± 1.44 vs 19.1 ± 18.5, p:0.007) and more decreases of the SaO2 (9.9 ± 5.15 vs 26.5 ± 17.81, p:0.011). 78% of the patients in hemodialysis suffered some sleep disorder, emphasizing the SAHS (48%). The serum creatinine and the eKt/v were independently associated with the AHI (R2: 0.219, p: 0.028). Conclusions: The sleep disorder is a prevalent pathology in the CKD. Patients in hemodialysis show a elevated AHI and of intermittent hypoxia, that must be avoided in these patients with an elevated cardiovascular mortality. Only, the levels of creatinine and the eKt/v explain partially the variability of the AHI. Objetivos: Respecto a población sana, se evalúan los trastornos del sueño en enfermos con enfermedad renal crónica estadio 4- 5 (ERC 4-5) y hemodiálisis. En estos últimos se estudia la prevalencia del síndrome de apneas-hipopneas del sueño (SAHS) y algún marcador analítico asociado independientemente al SAHS. Pacientes y Método: fueron estudiados 32 pacientes en hemodiálisis (24 hombres y 8 mujeres, edad: 54 ± 16, IMC: 25 ± 3.9), 14 enfermos con ERC 4-5 y 14 sujetos sanos. Estos dos últimos grupos, pareados por edad, género e IMC con el grupo en hemodiálisis. Se les realizó una historia clínica y una polisomnografía diagnóstica, estableciéndose el diagnóstico de SAHS ante un índice de apnea-hipopnea (IAH) ? 10. Resultados: Respecto al grupo control sano, los pacientes con ERC 4-5 muestran peo