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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Biomarkers, Blood Proteins, Cause of Death, Female, Humans, Hypoxia, Kaplan-Meier Estimate, Kidney Failure, Chronic, Male, Middle Aged, Natriuretic Peptide, Brain, Nocturnal Myoclonus Syndrome, Oxygen, Polysomnography, Proportional Hazards Models, Renal Dialysis, Republic of Korea, Risk Assessment, Risk Factors, Sleep, Sleep Apnea Syndromes, Time Factors, Troponin T, Young Adult, alpha-2-HS-Glycoprotein.
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Do nocturnal hypoxemia and periodic limb movement predict mortality in patients on maintenance hemodialysis? Context: Sleep disorders, including sleep-disordered breathing and periodic limb movements during sleep, are associated with an increased risk for cardiovascular diseases, which are the leading causes of death in patients with ESRD. This study investigated the association between sleep disorders and mortality in patients with ESRD. Thirty patients on maintenance hemodialysis, who were clinically stable for >2 months, underwent overnight polysomnography to evaluate sleep parameters. All patients were followed for a median of 48 months (range: 14 to 62 months), and 14 of them died during the follow-up period. Among the sleep parameters, the percent of sleep time with arterial oxygen saturation <90% (T <90%), mean arterial oxygen saturation, and periodic limb movement index score were associated with significant increases in the risk of death. However, associations of the apnea-hypopnea index or oxygen desaturation index with mortality were NS. The hazard ratios (95% confidence intervals) for death per one SD increment in the log-transformed T <90% and periodic limb movement index score were 2.10 (1.06 to 4.15) and 2.48 (1.11 to 5.52), respectively, after adjusting for age.
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We found that nocturnal hypoxemia and periodic limb movement during sleep, rather than apnea itself, were associated with an increased risk for death in patients with ESRD. However, conclusions from this study should be drawn with caution, because they are limited by the small sample size. Final Decision: yes