Is fluid overload a target to treat sleep disordered breathing in patients with end-stage renal disease, and what are the underlying mechanisms?

Michael Arzt, Danny J. Eckert

Research output: Contribution to journalEditorial

3 Citations (Scopus)

Abstract

Sleep problems are more common in patients with renal failure compared to populations without overt severe comorbidities. Both central and obstructive forms of sleep disordered breathing (SDB) are present in patients with renal failure [1, 2]. Other sleep problems, including restless leg syndrome, periodic limb movement syndrome and insomnia, also occur at high rates in this population. As the severity of renal impairment increases so too does the prevalence and severity of sleep disorders [3, 4]. Indeed, in end-stage renal disease, significant SDB (apnoea–hypopnoea index ≥15 per hour sleep) can occur in up to 70% of cases, regardless of whether such patients are on haemodialysis or peritoneal dialysis [5, 6].

Depending on the severity of disease, prior to or in conjunction with implementation of specific therapies for SDB such as positive airway pressure, attempts to alleviate SDB with recommendations such as weight loss, cessation of alcohol consumption, as well as treatment of the underlying disease that may worsen SDB are justified. To direct treatment of SDB in patients with end-stage renal failure it is crucial to increase understanding of the underlying pathophysiology of SDB in this patient population.
Original languageEnglish
Article number1700443
JournalEuropean Respiratory Journal
Volume49
Issue number4
DOIs
Publication statusPublished - 2017
Externally publishedYes

Keywords

  • Sleep disordered breathing
  • end-stage renal disease (ESRD)
  • fluid overload

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