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العنوان
Effect of Predialysis Fluid Overload on Quality of Sleep in Patients Undergoing Hemodialysis \
المؤلف
Ali, Mohamed Arafa Ahmed.
هيئة الاعداد
باحث / محمد عرفه احمد
مشرف / هيثم عزات عبد العزيز
مشرف / حسين سيد حسين
مشرف / أحمد عبد المنعم عبد المجيد عماره
تاريخ النشر
2019.
عدد الصفحات
136 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
الطب الباطني
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - امراض الباطنة
الفهرس
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Abstract

Sleep disorders are common among the patients undergoing dialysis in end stage renal disease (ESRD). Although variable, their prevalence has been reported to be higher when compared to the general population, the poor sleep quality in the HD patients leads to poor quality of life and higher morbidity and mortality rates.

The etiology of sleep disorders in patients on dialysis is multifactorial, however, as fluid overload is one of the major presentations in hemodialysis patients we tried to explore the association between predialysis fluid overload and poor sleep quality in HD patients.
The aim of the work is to study the effect of predialysis fluid overload on sleep quality in hemodialysis patients.

This cross-sectional study was conducted between January and March 2019 and consisted of 100 patients undergoing hemodialysis in hemodialysis unit of el Sahel teaching hospital.
We excluded people with conditions known to cause sleep disturbances as Decompensated liver or cardiac disease, malignancies, psychiatric disorders, recent infection, Concurrent diagnosis of obstructive sleep Apnea and patients on any medications which affect the sleep pattern.

All participants were thoroughly interrogated and examined clinically and were subjected to blood urea , creatinine , Na , K , Ca , Po4 ,PTH, Hb , Hct , Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess the quality of sleep with cutoff value (total PSQI score ≥ 5) , Body Compositions Monitor (BCM) to asses fluid status befor mid-week dialysis session with cutoff value (OH/ECW ≥15%).
According to the fluid status, patients were classified into 2 main groups: group 1 (non- overhydrated group) OH/ECW <15% and group 2 (Overhydrated group) OH/ECW ≥ 15%.
Results of the study demonstrated that prevalence of poor sleep quality was significantly higher in patients with predialysis overhydration (group 2) about 69.05% compared to patients without overhydration (group 1) about 30.95%, though 57% of all HD patients included in our study reported poor quality of sleep .we found more hypertensive patients in group 2 (overhydrated). There was significant difference between the 2 groups as regard gender with high male percentage in group 2 (overhydrated) with 61.9% (N=26) of 42 overhydrated HD patients ,but there was no significant difference between the two groups as regard age, DM, HCV or the duration of the dialysis. Our study showed highly significant differences between the two groups as regard total (PSQI) scores with higher scores in group 2 (overhydrated) than in group 1 (non-overhydrated) with mean(7.92+3.32 vs 4.83+2.27 p= <0.001).
Moreover, there was positive correlation between total PSQI score and both: overhydration (OH) and overhydration index (OH/ECW %) in all HD patients included in the study, but when repeated in each group separately, no significant correlation was found.

Conclusion:
Our results demonstrated that hemodialysis patients with overhydration have poor quality of sleep if compared with non-overhydrated patients.