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• W3001232489 abstract "Daytime sleepiness, also known as hypersomnolence, is common among patients receiving maintenance dialysis and following successful kidney transplantation. Sleepiness may be secondary to medical comorbid conditions, medication side effect, insufficient sleep syndrome, and sleep-disordered breathing or the result of a primary central disorder of hypersomnolence, such as narcolepsy. Unrecognized and untreated sleep disorders are associated with substantial morbidity and mortality among patients with end-stage kidney disease. Effective management of hypersomnolence can improve quality of life in patients with kidney disease. This review focuses on the principal causes of sleepiness in patients with end-stage kidney disease. Awareness of these disorders by treating nephrologists is crucial. This review provides a systematic approach to guide providers through the recognition, early diagnosis, and treatment of hypersomnolence, which is commonly encountered in this patient population. Areas of future research are also suggested. Daytime sleepiness, also known as hypersomnolence, is common among patients receiving maintenance dialysis and following successful kidney transplantation. Sleepiness may be secondary to medical comorbid conditions, medication side effect, insufficient sleep syndrome, and sleep-disordered breathing or the result of a primary central disorder of hypersomnolence, such as narcolepsy. Unrecognized and untreated sleep disorders are associated with substantial morbidity and mortality among patients with end-stage kidney disease. Effective management of hypersomnolence can improve quality of life in patients with kidney disease. This review focuses on the principal causes of sleepiness in patients with end-stage kidney disease. Awareness of these disorders by treating nephrologists is crucial. This review provides a systematic approach to guide providers through the recognition, early diagnosis, and treatment of hypersomnolence, which is commonly encountered in this patient population. Areas of future research are also suggested. FEATURE EDITOR:Holly KramerADVISORY BOARD:Linda FriedAna RicardoRoger RodbyRobert TotoIn Practice is a focused review providing in-depth guidance on a clinical topic that nephrologists commonly encounter. Using clinical vignettes, these articles illustrate a complex problem for which optimal diagnostic and/or therapeutic approaches are uncertain. FEATURE EDITOR: Holly Kramer ADVISORY BOARD: Linda Fried Ana Ricardo Roger Rodby Robert Toto In Practice is a focused review providing in-depth guidance on a clinical topic that nephrologists commonly encounter. Using clinical vignettes, these articles illustrate a complex problem for which optimal diagnostic and/or therapeutic approaches are uncertain. PJ is a 52-year-old woman with end-stage kidney disease (ESKD) in the setting of long-standing type 2 diabetes mellitus and hypertension who has been receiving in-center hemodialysis for the past 2 years. She reports chronic fatigue, difficulty concentrating, and trouble staying awake. She has been falling asleep while using the computer and recently received a formal warning at work. She states that she has fallen asleep at the dinner table and while talking on the telephone with friends. She usually retires to bed at 11:00 pm and falls asleep with the television on after midnight. She has 1 to 2 brief nocturnal awakenings and wakes up at 5:00 am on dialysis days. On nondialysis weekdays, she wakes up at 10:00 am to get to her part-time job. She sleeps until noon on weekends. On her last vacation, her sister commented about her loud snoring. She drinks 4 cups of coffee daily to stay awake. Dialysis has been going well, and last month’s delivered Kt/V was 1.4. Her diabetes is well-controlled with low-dose insulin, but her blood pressure remains elevated at 149/82 mm Hg despite good adherence to treatment with 3 antihypertensive agents. Her body mass index is 29 kg/m2. She is currently active on the kidney transplant waiting list." @default.
• W3001232489 created "2020-01-30" @default.
• W3001232489 creator A5046349771 @default.
• W3001232489 creator A5050014069 @default.
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• W3001232489 date "2020-05-01" @default.
• W3001232489 modified "2023-10-02" @default.
• W3001232489 title "A Guide to Management of Sleepiness in ESKD" @default.
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• W3001232489 doi "https://doi.org/10.1053/j.ajkd.2019.09.010" @default.
• W3001232489 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/31983503" @default.
• W3001232489 hasPublicationYear "2020" @default.
• W3001232489 type Work @default.

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