Obstructive Sleep Apnea Clinical Trial
Official title:
Prospective Interventional Study Investigating the Effect of Renal Transplantation on Obstructive Sleep Apnea and Its Correlation to Nocturnal Rostral Fluid Shift, in End Stage Renal Disease Patients
The purpose of this study is to investigate the effect of renal transplantation on fluid overload and its consequence on the severity of obstructive sleep apnea, in patients with end stage chronic kidney disease. It aims further to investigate the relationship between overhydration, nocturnal rostral fluid shift and the severity of sleep apnea.
Obstructive sleep disordered breathing is more prevalent in end stage kidney disease patients
than in the general population, and may participate to the increased cardiovascular mortality
observed in this group of patients. Despite a significant increase in knowledge about the
harmful effects of obstructive sleep apnea, the pathophysiological mechanisms are poorly
understood. Recent observations suggest a causative relationship between overnight fluid
displacement from the legs to the neck soft and the severity of obstructive sleep apnea. This
mechanism was demonstrated in otherwise healthy subjects, in heart failure patients, and in
patients with venous insufficiency. We thus suspect that this pathophysiologic mechanism
could explain the increased prevalence of obstructive sleep apnea in patients with fluid
overload, including chronic renal failure.
The purpose of this study is to investigate the effect of renal transplantation on fluid
overload and its consequence on the severity of obstructive sleep apnea, in patients with end
stage chronic kidney disease. It aims further to investigate the relationship between
overhydration, nocturnal rostral fluid shift and the severity of sleep apnea.
The severity of obstructive sleep apnea is measured by two attended polysomnographies, a
baseline PSG performed before and a follow-up PSG performed 6 month after renal
transplantation. Overhydration and leg fluid are evaluated by bioimpedance, performed at the
beginning and at the end of each polysomnography. Patients who are not already transplanted 6
months after the baseline PSG will be re-assessed and will be analyzed as control group.
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