Benedetto FA, Tripepi G, Cambareri F, Panuccio V, Enia V, Mallamaci F, Zoccali C, Tassone F
Hypertension and nocturnal hypoxemia in chronic renal failure
12th Annual ASH Meeting
Am J Hypertens (Apr) 10:192A 1997

The relatively high prevalence of sleep apnea in ESRD patients is increasingly recognized. Transient hypoxia elicits pathophysiologic responses which include hypertension. A significant group of ESRD patients are "non-dippers", i.e. they do not show a normal fall in BP during sleep. This study aims at correlating these two phenomena.

Thirty-two ESRD patients (HD and PD percentages were not given) underwent 24 hour ambulatory BP monitoring with nocturnal pulse oximetry recording. 13 (41%) did not desaturate; 19 desaturated at least once, and 12 (38%) desaturated 10 or more times. Daytime SBP in these patients with frequent desaturation were no different from SBP in those without desaturation, but nocturnal SBP rose in the former and fell in the latter group.

Comment: It thus appears that aside from the expected acute rises in SBP during desaturation, these patients. are "non-dippers". The entire topic of sleep disorders and nocturnal BP control in ESRD is of increasing interest, particularly in view of the potential impact on mortality. The abstract lacks some of the demographic comparisons of the groups, especially weight and underlying lung disease. (James A. Sondheimer MD, Wayne State University, Detroit, MI)

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12th Annual ASH Meeting
H: Pathophysiology : Sleep, sleep apnea