{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T13:00:00Z","timestamp":1769000400760,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,5,5]],"date-time":"2015-05-05T00:00:00Z","timestamp":1430784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Obstructive sleep apnea (<jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>) is common, underdiagnosed, and undertreated among patients with end\u2010stage renal disease (<jats:styled-content style=\"fixed-case\">ESRD<\/jats:styled-content>). As in all cases, pathogenesis of <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content> is related to repeated upper airway (<jats:styled-content style=\"fixed-case\">UA<\/jats:styled-content>) occlusion or narrowing, but in <jats:styled-content style=\"fixed-case\">ESRD<\/jats:styled-content>, additional contributory factors likely include uremic destabilization of central respiratory control and anatomic changes in the <jats:styled-content style=\"fixed-case\">UA<\/jats:styled-content> related to fluid status. Pulmonary congestion is common in acute and chronic kidney failure and is a consequence of cardiomyopathy and fluid overload, two potentially reversible risk factors. Emerging evidence suggests that volume overload also reduces the <jats:styled-content style=\"fixed-case\">UA<\/jats:styled-content> caliber. The diminution in <jats:styled-content style=\"fixed-case\">UA<\/jats:styled-content> area as well as destabilization of ventilatory control in <jats:styled-content style=\"fixed-case\">ESRD<\/jats:styled-content> have been postulated as causes of increased <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content> prevalence and severity in these patients, and creates a vicious cycle wherein <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content> exacerbates fluid overload disorders such as in congestive heart failure (<jats:styled-content style=\"fixed-case\">CHF<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">ESRD<\/jats:styled-content>, which then further worsen <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>. Dialysis modalities may differ in their effects on volume status, the accumulation of uremic toxins, and acid\u2013base status, and as a consequence, on the emergence and severity of <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>. Given the contribution of excess fluid to both the severity of nocturnal hypoxia and <jats:styled-content style=\"fixed-case\">UA<\/jats:styled-content> narrowing, establishing and maintaining dry weight is of particular importance when managing <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">ESRD<\/jats:styled-content>. Clinical trials to determine the extent to which more aggressive fluid removal in <jats:styled-content style=\"fixed-case\">ESRD<\/jats:styled-content> patients may alleviate <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content> are needed.<\/jats:p>","DOI":"10.1111\/sdi.12389","type":"journal-article","created":{"date-parts":[[2015,5,5]],"date-time":"2015-05-05T05:33:26Z","timestamp":1430804006000},"page":"508-513","source":"Crossref","is-referenced-by-count":19,"title":["The Relationship Between Volume Overload in End\u2010Stage Renal Disease and Obstructive Sleep Apnea"],"prefix":"10.1111","volume":"28","author":[{"given":"Maria\u2010Eleni","family":"Roumelioti","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine University of New Mexico School of Medicine Albuquerque New Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee K.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division 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