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Vol. 44. Issue 7.
Pages 371-375 (January 2008)
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Vol. 44. Issue 7.
Pages 371-375 (January 2008)
Original Articles
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Sleep Disorders in Patients on a Kidney Transplant Waiting List
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Bernabé Jurado Gámeza,
Corresponding author
bjg01co@hotmail.com

Correspondence: Dr B. Jurado Gámez, Servicio de Neumología (UTRS), Hospital Reina Sofía, Avda. Menéndez Pidal, s/n, 14004 Cordoba, Spain
, Alejandro Martín-Malob, Mari Carmen Fernández Marína, Alberto Rodríguez-Benotb, Natalia Pascuala, Luis Muñoz Cabreraa, Pedro Aljamab
a Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
b Servicio de Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain
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Objective

To evaluate the prevalence of sleep disorders in patients awaiting kidney transplants compared to a control group.

Patients and methods

We carried out an observational study of 23 patients on a kidney transplant waiting list in comparison with 20 healthy volunteers matched for age, sex, and body mass index (BMI). Overnight polysomnography was performed and a diagnosis of sleep apnea-hypopnea syndrome (SAHS) established when the apnea-hypopnea index (AHI) was 10 or higher.

Results

Eighty-two percent of the patients awaiting kidney transplants (16 men and 7 women with a mean [SD] age of 51 [15] years and a mean BMI of 25 [3.8] kg/m2) had some type of sleep disorder. The most frequent disorders were SAHS (48%) and insomnia and periodic limb movement disorder (30%). Patients showed poorer sleep efficiency compared to the control group (75.4% vs 87.8%; P=.01) and a lower percentage of slow-wave and rapid eye movement sleep (24.5% vs 40%; P=.001). Those with sleep-disordered breathing had a higher AHI (17.7 vs 3.6; P=.00l) and oxygen desaturation index (31.5 compared to 8.2; P=.00l).

Conclusions

Sleep disorders are common in patients awaiting kidney transplants. Such patients show reduced quantity and quality of sleep compared to controls and a significantly elevated number of respiratory events that may affect morbidity and mortality.

Key words:
Apnea-hypopnea index
Oxygen desaturation index
Chronic renal failure
Kidney transplantation
Sleep disorders
Sleep-disordered breathing
Objetivo

Valorar la prevalencia de los trastornos del sueno en pacientes en lista de espera de trasplante renal, comparados con un grupo control.

Pacientes y métodos

Se ha realizado un estudio observacional en 23 pacientes en lista de espera para trasplante renal, cuyos resultados se compararon con los de 20 personas sanas que accedieron voluntariamente a participar en él. Se empare-jaron por edad, sexo e indice de masa corporal. Se efectuó una polisomnografía de noche completa y el diagnóstico de síndro-me de apneas-hipopneas durante el sueño se estableció cuando el índice de apneas-hipopneas era como mínimo de 10.

Resultados

Los pacientes en lista de espera para trasplante renal (16 varones y 7 mujeres; edad media ± desviación estáandar: 51 ± 15 años; índice de masa corporal: 25 ± 3,8 kg/m2) presentaron en un 82% de los casos algún trastorno del sueño. Los más frecuentes fueron el síndrome de apneas-hipopneas durante el sueñssso (48%) e insomnio y síndrome de movimiento periódico de piernas (30%). Los pacientes presentaron, respecto al grupo control, una menor eficiencia del sueño (el 75,4 frente al 87,8%; p = 0,01) y un menor porcentaje de sueño de ondas lentas y REM (un 24,5 frente a un 40%; p = 0,001), mientras que los trastornos respiratorios del sueño mostraron un mayor índice de apneas-hipopneas (17,7 frente a 3,6; p = 0,001) e indice de desaturación (31,5 frente a 8,2; p = 0,001).

Conclusiones

Los trastornos del sueño son frecuentes en pacientes en lista de espera para trasplante renal, quienes, respecto al grupo control, tienen una menor cantidad y calidad del sueño, con un número significativamente elevado de eventos respiratorios, que pueden influir en la morbimortalidad.

Palabras clave:
Índice de apneas-hipopneas del sueño
Índice de desaturación
Insuficiencia renal crónica
Trasplante renal
Trastornos del sueño
Trastornos respiratorios del sueño
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Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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