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      Insomnia in Diabetic Hemodialysis Patients

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          Abstract

          Background: Insomnia is one of the most common problems in dialysis patients, and likely to contribute impairment in quality of life, which has a positive correlation with patients’ survival. In diabetic patients, morbidity and mortality are substantially higher than in the nondiabetic counterparts, and also the incidence of sleep disturbances. However, there is no means to predict sleep disturbance in the dialysis patients especially in diabetics. To define the prevalence and risk factors for insomnia in diabetic patients on hemodialysis, we undertook a cross-sectional multicenter study. Methods: Eighty-two diabetic patients (50 men/32 women, aged 58.7 ± 9.23 years) on maintenance hemodialysis for more than 6 months from 12 different hospitals were enrolled. The demographic data, subjective symptoms, depression scale, and insomnia were assessed by questionnaires, and lean body mass, BMI, Kt/V, subjective global assessment, nursing assessment score (NAS), and biochemical parameters were examined. Results: The number of patients with and without insomnia were 56 and 26, respectively, which amounted to 68.2% for insomnia. NAS (28.1 ± 3.81 vs. 30.8 ± 2.88, p = 0.002), serum albumin concentration (3.82 ± 0.44 vs. 4.09 ± 0.36 g/dl, p = 0.008), and depression scale (25.2 ± 12.1 vs. 18.9 ± 10.3, p = 0.025) were significantly different between them. Patients with insomnia were older (60.5 ± 9.0 vs. 56. 1 ± 9.60 years, p = 0.053) and felt pain (38.5 vs. 15.3%, p = 0.06) more frequently than those without insomnia. The scale of depression was correlated with NAS (r = –0.455, p < 0.001) and the serum albumin concentration was correlated with NAS (r = 0.337, p = 0.002). NAS, age, and serum albumin concentration were the major risk factors for insomnia in logistic regression analysis. Conclusion: The prevalence of insomnia in diabetic hemodialysis patients was 68.2%. Age, nutritional status, and depression were the major risk factors for sleep disturbance in diabetic patients.

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          Most cited references 2

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          Reversal of sleep apnea in uremia by dialysis

           A. Fein (1987)
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            Sodium balance and blood pressure response to salt ingestion in uninephrectomized rats

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              Author and article information

              Journal
              NEF
              Nephron
              10.1159/issn.1660-8151
              Nephron
              S. Karger AG
              1660-8151
              2235-3186
              2002
              September 2002
              14 August 2002
              : 92
              : 1
              : 127-132
              Affiliations
              aDepartment of Internal Medicine, Korea University, bKangbuck Samsung Medical Center, cKwangmyung Sungae Hospital, dDongkug University, eSongnam Central Hospital, fAnkuk Hospital, g Oh’s Clinic, hChung’s Clinic, iSeoul Red-Cross Hospital, Seoul
              Article
              64460 Nephron 2002;92:127–132
              10.1159/000064460
              12187095
              © 2002 S. Karger AG, Basel

              Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

              Page count
              Tables: 4, References: 42, Pages: 6
              Product
              Self URI (application/pdf): https://www.karger.com/Article/Pdf/64460
              Categories
              Original Paper

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