The Japanese Journal of Clinical Dialysis Vol.18 No.2(3)

Theme Sleep Apnea Syndrome in Maintenance Hemodialysis Patients
Title Uremia and sleep apnea syndrome (SAS)
Publish Date 2002/02
Author Masuo Terashima Division of Nephrology, Tokai University School of Medicine
Author Akira Saito Division of Nephrology, Tokai University School of Medicine
[ Summary ] The incidence of sleep apnea syndrome (SAS) in chronic renal failure patients is high, compared to normal subjects. The incidence and severity of SAS between HD and CAPD patients is not markedly different. In chronic renal failure patients, the accumulation of uremic toxins, metabolic acidosis, chronic hypocapnia, osmotic inbalances, changes in cytokine levels, and cerebrovascular disease are considered to induce disturbances of the chemical receptors for respiration (central SAS) and to induce hypotonicity of respiratory muscles, which leads to the collapse of the upper respiratory tract (obstructive SAS). Conventional HD therapy, does not modulate the severity of SAS. Nocturnal hemodialysis and renal transplantation, remarkably improve SAS conditions. Daily long term hemodialysis therapy or renal transplantation are recomended as therapeutic modes for SAS. SAS, induces autonomic nerve disturbances, which lead to hypertension, arrythmia, ischemic heart disease, cerebrovascular disease and pulmonary circulation disease. The diagnosis and therapy of SAS is an importantissue in the treatment of chronic renal failure patients.
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