Significant interdialytic weight gain in patients on hemodialysis (HD) is associated with obstructive sleep apnea (OSA), a Brazilian study found.
In a study of 55 HD patients (49% male) with low cardiovascular risk, Rebeca R. Harmon, MD, of the University of São Paulo Medical School Hospital, and colleagues found that patients with OSA had a significantly greater proportion of those with an interdialytic weight gain of more than 2 kg than those without OSA (96% vs 55%), according to a report published online ahead of print in Sleep and Breathing.
In addition, patients with OSA had significantly greater left ventricular (LV) posterior wall thickness (11.3 vs 10.0 mm) and LV diastolic diameter (53 vs 48 mm) compared with those who did not have OSA. Sleep questionnaires did not predict OSA. The investigators found no significant differences in pulse wave velocity, carotid intima-media thickness, and ankle-brachial index between those with and without OSA. On multivariate analysis, interdialytic weight gain greater than 2 kg and LV diastolic diameter were independently associated with OSA. After a median follow-up of 45 months, OSA was associated with a significantly higher incidence of cardiovascular events (28% vs 7%).
Harmon RR, De Lima JJG, Drager LF, et al. Obstructive sleep apnea is associated with interdialytic weight gain and increased cardiovascular events in hemodialysis patients. Sleep Breath. 2017; published online ahead of print.