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NDT Advance Access originally published online on May 7, 2008
Nephrology Dialysis Transplantation 2008 23(8):2704; doi:10.1093/ndt/gfn145
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


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E-mail: christopher.chan{at}uhn.on.ca

Sir,

We thank Dr Sakkas and colleagues for their interest in our recent article demonstrating the impact of nocturnal home haemodialysis on exercise capacity and duration [1]. We agree with Sakkas et al. that exercise intolerance as exhibited by patients with end-stage renal disease (ESRD) is likely to be multifactorial [2,3].

Excessive daytime sleep and sleep disorders, including sleep apnoea syndrome, occur with increased frequency in patients with ESRD [4]. Although the exact contribution of sleep disorders, particularly sleep apnoea syndrome, on physical intolerance is unknown in ESRD, as similar observations were made with patients with heart failure and central sleep apnoea treated with continuous positive airway pressure [5].

To date, there is an emerging body of literature indicating the effect of intensive haemodialysis on various surrogate outcomes. The ultimate impact of nocturnal haemodialysis on the mortality of ESRD patients remained to be clarified.

Conflict of interest statement. None declared.

Christopher T Chan

Department of Medicine, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada

References

  1. Chan CT, Notarius CF, Merlocco AC, et al. Improvement in exercise duration and capacity after conversion to nocturnal home haemodialysis. Nephrol Dial Transplant (2007) 22:3285–3291.[Abstract/Free Full Text]
  2. Johansen KL, Chertow GM, da Silva M, et al. Determinants of physical performance in ambulatory patients on hemodialysis. Kidney Int (2001) 60:1586–1591.[CrossRef][Web of Science][Medline]
  3. Painter P. Physical functioning in end-stage renal disease patients: update. Hemodial Int (2005) 9:218–235.[CrossRef][Medline]
  4. Perl J, Unruh ML, Chan CT. Sleep disorders in end-stage renal disease: ‘Markers of inadequate dialysis?’ Kidney Int (2006) 70:1687–1693.[CrossRef][Web of Science][Medline]
  5. Bradley TD, Logan AG, Kimoff RJ, et al. Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med (2005) 353:2025–2033.[Abstract/Free Full Text]

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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
23/8/2704    most recent
gfn145v1
Right arrow Alert me when this article is cited
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Right arrow Email this article to a friend
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