Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise

Detalhes bibliográficos
Autor(a) principal: Santos, Israel dos Reis dos
Data de Publicação: 2016
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da Uninove
Texto Completo: http://bibliotecatede.uninove.br/handle/tede/1838
Resumo: Introduction: Sleep disorders are common all over the world and have profound effects on modern industrialized societies "24 hours". Obstructive sleep apnea (OSA) has a high morbidity and mortality, associated with a prevalence of 9.6% in women and 24.8% in men in the general population. OSA is more prevalent in chronic end-stage renal disease (CKD) and is associated with systemic arterial hypertension (SAH), left ventricular hypertrophy and increased mortality. Although OSA is characterized by repetitive collapse of the upper airway (VAS) during sleep, its cause is still not completely established. The observation that OSA is more prevalent in patients with edematous states, such as heart failure and ESRD than in the general population, raises the possibility that fluid retention may increase the risk of OSA. Objectives: To verify the behavior of the apnea/hypopnea index in the interdialytic period in patients with CKD. Methods: A consecutive cross-sectional clinical study was conducted to investigate the behavior of sleep apnea/hypopnea index (AHI) in patients with CKD undergoing HD at the Unidade de Nefrologia (UNEFRO) at Hospital Santa Casa de Miseric??rdia in Avar??, (SP) and Centro de Nefrologia Zona Norte - CENENORTE, S??o Paulo (SP), Brazil. The design and conduct of this study followed the guidelines of the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) statement. Results: In the first phase of the study, 243 patients were evaluated, with 61.32% of males, with a mean age of 57 years, presenting as baseline SAH (46.3%), DM (38.8% ), Glomeronephritis (4.7%) and other diseases (10.3%). In the second phase, 18 patients underwent home night time polygraphy at night after HD and two subsequent nights using a portable cardiorespiratory monitoring device Apnea Link Air (ResMed Corporation, San Diego, CA, USA). The clinical and demographic characteristics of the population involved in this study are very similar to those described in the literature, emphasizing the predominance of patients with SAH and DM as the underlying disease. In relation to excessive daytime sleepiness, a high prevalence was observed. When we analyzed the risk for OSA, a large number of patients with a high risk of apnea were observed through the Berlin clinical questionnaire. As for the quality of life, a commitment was observed in all aspects related to the physical and mental domains, showing a marked commitment. Preliminary data from the study with polygraphs showed that AHI showed a significant change in the interdialytic period, showing the influence of rostraine fluids on the magnitude of obstructive respiratory events during sleep. Conclusions: This important finding allows new investigations regarding the use of noninvasive ventilatory support during sleep in patients with CKD submitted to HD, which may improve sleep quality, as well as reduce cardiovascular risk, the main cause of morbidity and mortality in this population
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spelling Oliveira, Luis Vicente Franco deOliveira, Luis Vicente Franco deSampaio, Luciana Maria Malos??Vieira, Rodolfo de PaulaAlves, Vera Lucia dos SantosNacif, Sergio Robertohttp://lattes.cnpq.br/2200066267825390Santos, Israel dos Reis dos2018-07-16T21:25:37Z2016-12-15Santos, Israel dos Reis dos. Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise. 2016. 68 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.http://bibliotecatede.uninove.br/handle/tede/1838Introduction: Sleep disorders are common all over the world and have profound effects on modern industrialized societies "24 hours". Obstructive sleep apnea (OSA) has a high morbidity and mortality, associated with a prevalence of 9.6% in women and 24.8% in men in the general population. OSA is more prevalent in chronic end-stage renal disease (CKD) and is associated with systemic arterial hypertension (SAH), left ventricular hypertrophy and increased mortality. Although OSA is characterized by repetitive collapse of the upper airway (VAS) during sleep, its cause is still not completely established. The observation that OSA is more prevalent in patients with edematous states, such as heart failure and ESRD than in the general population, raises the possibility that fluid retention may increase the risk of OSA. Objectives: To verify the behavior of the apnea/hypopnea index in the interdialytic period in patients with CKD. Methods: A consecutive cross-sectional clinical study was conducted to investigate the behavior of sleep apnea/hypopnea index (AHI) in patients with CKD undergoing HD at the Unidade de Nefrologia (UNEFRO) at Hospital Santa Casa de Miseric??rdia in Avar??, (SP) and Centro de Nefrologia Zona Norte - CENENORTE, S??o Paulo (SP), Brazil. The design and conduct of this study followed the guidelines of the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) statement. Results: In the first phase of the study, 243 patients were evaluated, with 61.32% of males, with a mean age of 57 years, presenting as baseline SAH (46.3%), DM (38.8% ), Glomeronephritis (4.7%) and other diseases (10.3%). In the second phase, 18 patients underwent home night time polygraphy at night after HD and two subsequent nights using a portable cardiorespiratory monitoring device Apnea Link Air (ResMed Corporation, San Diego, CA, USA). The clinical and demographic characteristics of the population involved in this study are very similar to those described in the literature, emphasizing the predominance of patients with SAH and DM as the underlying disease. In relation to excessive daytime sleepiness, a high prevalence was observed. When we analyzed the risk for OSA, a large number of patients with a high risk of apnea were observed through the Berlin clinical questionnaire. As for the quality of life, a commitment was observed in all aspects related to the physical and mental domains, showing a marked commitment. Preliminary data from the study with polygraphs showed that AHI showed a significant change in the interdialytic period, showing the influence of rostraine fluids on the magnitude of obstructive respiratory events during sleep. Conclusions: This important finding allows new investigations regarding the use of noninvasive ventilatory support during sleep in patients with CKD submitted to HD, which may improve sleep quality, as well as reduce cardiovascular risk, the main cause of morbidity and mortality in this populationIntrodu????o: Os dist??rbios do sono s??o comuns em todo o mundo e apresentam profundos efeitos nas sociedades modernas industrializadas ???24 horas???. A apneia obstrutiva do sono (AOS) apresenta uma elevada morbimortalidade, associada a uma preval??ncia de 9,6% em mulheres e 24,8% em homens na popula????o geral. A AOS ?? mais prevalente na doen??a renal cr??nica terminal (DRCT) e est?? associada a hipertens??o arterial sist??mica (HAS), hipertrofia do ventr??culo esquerdo e aumento da mortalidade. Embora a AOS seja caracterizada pelo colapso repetitivo das vias a??reas superiores (VAS) durante o sono, a sua causa ainda n??o ?? completamente estabelecida. A observa????o de que a AOS ?? mais prevalente em pacientes que apresentam estados edematosos, como a insufici??ncia card??aca e DRCT mais do que na popula????o em geral, levanta a possibilidade de que a reten????o de fluidos pode aumentar o risco de AOS. Objetivos: Verificar o comportamento do indice de apn??ia/hipopn??ia no per??odo interdial??tico em pacientes com doen??a renal cr??nica terminal. Metodologia: Foi realizado um estudo cl??nico transversal, consecutivo, para investigar o comportamento do ??ndice de apneia/hipopneia por hora de sono (IAH) em pacientes com DRCT submetidos a HD na Unidade de Nefrologia (UNEFRO) no Hospital Santa Casa de Miseric??rdia de Avar??, (SP), e Centro de Nefrologia Zona Norte ??? CENENORTE, S??o Paulo (SP), Brasil. O desenho e a condu????o deste estudo seguiram as diretrizes do Strengthening Reporting of Observational Studies in Epidemiology (STROBE) statement. Resultados: Na primeira fase do estudo, foram avaliados 243 pacientes, sendo que 61,32% do sexo masculino, com m??dia de idade de 57 anos, apresentando como doen??a de base HAS (46,3%), DM (38,8%), glomeronefrite (4,7%) e outras doen??as (10,3%). Na segunda fase, participaram 18 pacientes que realizaram a poligrafia noturna domiciliar na noite ap??s a HD e em duas noites subsequentes usando um equipamento de monitoramento cardiorrespirat??rio port??til tipo Apnea Link Air (ResMed Corporation, San Diego, CA, EUA). As caracter??sticas clinicas e demogr??ficas da popula????o envolvida neste estudo s??o muito semelhantes ??s descritas na literatura, ressaltando o predom??nio de pacientes com HAS e DM como doen??a de base. Em rela????o ?? sonol??ncia excessiva diurna, foi observado uma grande preval??ncia. Ao analisarmos o risco para AOS, atrav??s do question??rio cl??nico de Berlin, foi observado um consider??vel n??mero de pacientes apresentando alto risco para apneia. Quanto a qualidade de vida, foi observado um comprometimento em todos os aspectos relacionados aos dom??nios f??sico e mental, mostrando um acentuado comprometimento. Os dados preliminares do estudo realizado com as poligrafias, demonstraram que o IAH apresentou uma altera????o significativa no per??odo interdialitico, mostrando a influ??ncia dos flu??dos rostrais na magnitude dos eventos respirat??rios obstrutivos durante o sono. Conclus??es: Este importante achado, possibilita novas investiga????es quanto ao uso do suporte ventilat??rio n??o invasivo durante o sono em pacientes com DRC submetidos ?? HD, o que pode melhorar a qualidade do sono, bem como reduzir o risco cardiovascular, principal causa de morbimortalidade desta popula????oSubmitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-16T21:25:37Z No. of bitstreams: 1 Israel dos Reis dos Santos.pdf: 1818241 bytes, checksum: 29460be68638424919ccf1302b00298a (MD5)Made available in DSpace on 2018-07-16T21:25:37Z (GMT). No. of bitstreams: 1 Israel dos Reis dos Santos.pdf: 1818241 bytes, checksum: 29460be68638424919ccf1302b00298a (MD5) Previous issue date: 2016-12-15application/pdfporUniversidade Nove de JulhoPrograma de P??s-Gradua????o em Ci??ncias da Reabilita????oUNINOVEBrasilSa??dedist??rbios do sonoapneia obstrutiva do sonomonitoramento cardiorrespirat??rioqualidade de vidasleep disordersobstructive sleep apneacardiorespiratory monitoringquality of lifeCIENCIAS DA SAUDEEstudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??liseStudy of sleep, risk apnea, excessive daytime sleepiness and quality of life of patients with chronic rend disease undergoing hemodialysisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis8765449414823306929600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALIsrael dos Reis dos Santos.pdfIsrael dos Reis dos Santos.pdfapplication/pdf1818241http://localhost:8080/tede/bitstream/tede/1838/2/Israel+dos+Reis+dos+Santos.pdf29460be68638424919ccf1302b00298aMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82165http://localhost:8080/tede/bitstream/tede/1838/1/license.txtbd3efa91386c1718a7f26a329fdcb468MD51tede/18382018-07-16 18:25:37.422oai:localhost:tede/1838Tk9UQTogQ09MT1FVRSBBUVVJIEEgU1VBIFBSPz9QUklBIExJQ0VOPz9BCkVzdGEgbGljZW4/P2EgZGUgZXhlbXBsbyA/PyBmb3JuZWNpZGEgYXBlbmFzIHBhcmEgZmlucyBpbmZvcm1hdGl2b3MuCgpMSUNFTj8/QSBERSBESVNUUklCVUk/Pz8/TyBOPz9PLUVYQ0xVU0lWQQoKQ29tIGEgYXByZXNlbnRhPz8/P28gZGVzdGEgbGljZW4/P2EsIHZvYz8/IChvIGF1dG9yIChlcykgb3UgbyB0aXR1bGFyIGRvcyBkaXJlaXRvcyBkZSBhdXRvcikgY29uY2VkZSA/PyBVbml2ZXJzaWRhZGUgClhYWCAoU2lnbGEgZGEgVW5pdmVyc2lkYWRlKSBvIGRpcmVpdG8gbj8/by1leGNsdXNpdm8gZGUgcmVwcm9kdXppciwgIHRyYWR1emlyIChjb25mb3JtZSBkZWZpbmlkbyBhYmFpeG8pLCBlL291IApkaXN0cmlidWlyIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGE/Pz8/byAoaW5jbHVpbmRvIG8gcmVzdW1vKSBwb3IgdG9kbyBvIG11bmRvIG5vIGZvcm1hdG8gaW1wcmVzc28gZSBlbGV0cj8/bmljbyBlIAplbSBxdWFscXVlciBtZWlvLCBpbmNsdWluZG8gb3MgZm9ybWF0b3MgPz91ZGlvIG91IHY/P2Rlby4KClZvYz8/IGNvbmNvcmRhIHF1ZSBhIFNpZ2xhIGRlIFVuaXZlcnNpZGFkZSBwb2RlLCBzZW0gYWx0ZXJhciBvIGNvbnRlPz9kbywgdHJhbnNwb3IgYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YT8/Pz9vIApwYXJhIHF1YWxxdWVyIG1laW8gb3UgZm9ybWF0byBwYXJhIGZpbnMgZGUgcHJlc2VydmE/Pz8/by4KClZvYz8/IHRhbWI/P20gY29uY29yZGEgcXVlIGEgU2lnbGEgZGUgVW5pdmVyc2lkYWRlIHBvZGUgbWFudGVyIG1haXMgZGUgdW1hIGM/P3BpYSBhIHN1YSB0ZXNlIG91IApkaXNzZXJ0YT8/Pz9vIHBhcmEgZmlucyBkZSBzZWd1cmFuPz9hLCBiYWNrLXVwIGUgcHJlc2VydmE/Pz8/by4KClZvYz8/IGRlY2xhcmEgcXVlIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGE/Pz8/byA/PyBvcmlnaW5hbCBlIHF1ZSB2b2M/PyB0ZW0gbyBwb2RlciBkZSBjb25jZWRlciBvcyBkaXJlaXRvcyBjb250aWRvcyAKbmVzdGEgbGljZW4/P2EuIFZvYz8/IHRhbWI/P20gZGVjbGFyYSBxdWUgbyBkZXA/P3NpdG8gZGEgc3VhIHRlc2Ugb3UgZGlzc2VydGE/Pz8/byBuPz9vLCBxdWUgc2VqYSBkZSBzZXUgCmNvbmhlY2ltZW50bywgaW5mcmluZ2UgZGlyZWl0b3MgYXV0b3JhaXMgZGUgbmluZ3U/P20uCgpDYXNvIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGE/Pz8/byBjb250ZW5oYSBtYXRlcmlhbCBxdWUgdm9jPz8gbj8/byBwb3NzdWkgYSB0aXR1bGFyaWRhZGUgZG9zIGRpcmVpdG9zIGF1dG9yYWlzLCB2b2M/PyAKZGVjbGFyYSBxdWUgb2J0ZXZlIGEgcGVybWlzcz8/byBpcnJlc3RyaXRhIGRvIGRldGVudG9yIGRvcyBkaXJlaXRvcyBhdXRvcmFpcyBwYXJhIGNvbmNlZGVyID8/IFNpZ2xhIGRlIFVuaXZlcnNpZGFkZSAKb3MgZGlyZWl0b3MgYXByZXNlbnRhZG9zIG5lc3RhIGxpY2VuPz9hLCBlIHF1ZSBlc3NlIG1hdGVyaWFsIGRlIHByb3ByaWVkYWRlIGRlIHRlcmNlaXJvcyBlc3Q/PyBjbGFyYW1lbnRlIAppZGVudGlmaWNhZG8gZSByZWNvbmhlY2lkbyBubyB0ZXh0byBvdSBubyBjb250ZT8/ZG8gZGEgdGVzZSBvdSBkaXNzZXJ0YT8/Pz9vIG9yYSBkZXBvc2l0YWRhLgoKQ0FTTyBBIFRFU0UgT1UgRElTU0VSVEE/Pz8/TyBPUkEgREVQT1NJVEFEQSBURU5IQSBTSURPIFJFU1VMVEFETyBERSBVTSBQQVRST0M/P05JTyBPVSAKQVBPSU8gREUgVU1BIEFHPz9OQ0lBIERFIEZPTUVOVE8gT1UgT1VUUk8gT1JHQU5JU01PIFFVRSBOPz9PIFNFSkEgQSBTSUdMQSBERSAKVU5JVkVSU0lEQURFLCBWT0M/PyBERUNMQVJBIFFVRSBSRVNQRUlUT1UgVE9ET1MgRSBRVUFJU1FVRVIgRElSRUlUT1MgREUgUkVWSVM/P08gQ09NTyAKVEFNQj8/TSBBUyBERU1BSVMgT0JSSUdBPz8/P0VTIEVYSUdJREFTIFBPUiBDT05UUkFUTyBPVSBBQ09SRE8uCgpBIFNpZ2xhIGRlIFVuaXZlcnNpZGFkZSBzZSBjb21wcm9tZXRlIGEgaWRlbnRpZmljYXIgY2xhcmFtZW50ZSBvIHNldSBub21lIChzKSBvdSBvKHMpIG5vbWUocykgZG8ocykgCmRldGVudG9yKGVzKSBkb3MgZGlyZWl0b3MgYXV0b3JhaXMgZGEgdGVzZSBvdSBkaXNzZXJ0YT8/Pz9vLCBlIG4/P28gZmFyPz8gcXVhbHF1ZXIgYWx0ZXJhPz8/P28sIGFsPz9tIGRhcXVlbGFzIApjb25jZWRpZGFzIHBvciBlc3RhIGxpY2VuPz9hLgo=Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2018-07-16T21:25:37Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false
dc.title.por.fl_str_mv Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise
dc.title.alternative.eng.fl_str_mv Study of sleep, risk apnea, excessive daytime sleepiness and quality of life of patients with chronic rend disease undergoing hemodialysis
title Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise
spellingShingle Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise
Santos, Israel dos Reis dos
dist??rbios do sono
apneia obstrutiva do sono
monitoramento cardiorrespirat??rio
qualidade de vida
sleep disorders
obstructive sleep apnea
cardiorespiratory monitoring
quality of life
CIENCIAS DA SAUDE
title_short Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise
title_full Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise
title_fullStr Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise
title_full_unstemmed Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise
title_sort Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise
author Santos, Israel dos Reis dos
author_facet Santos, Israel dos Reis dos
author_role author
dc.contributor.advisor1.fl_str_mv Oliveira, Luis Vicente Franco de
dc.contributor.referee1.fl_str_mv Oliveira, Luis Vicente Franco de
dc.contributor.referee2.fl_str_mv Sampaio, Luciana Maria Malos??
dc.contributor.referee3.fl_str_mv Vieira, Rodolfo de Paula
dc.contributor.referee4.fl_str_mv Alves, Vera Lucia dos Santos
dc.contributor.referee5.fl_str_mv Nacif, Sergio Roberto
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/2200066267825390
dc.contributor.author.fl_str_mv Santos, Israel dos Reis dos
contributor_str_mv Oliveira, Luis Vicente Franco de
Oliveira, Luis Vicente Franco de
Sampaio, Luciana Maria Malos??
Vieira, Rodolfo de Paula
Alves, Vera Lucia dos Santos
Nacif, Sergio Roberto
dc.subject.por.fl_str_mv dist??rbios do sono
apneia obstrutiva do sono
monitoramento cardiorrespirat??rio
qualidade de vida
topic dist??rbios do sono
apneia obstrutiva do sono
monitoramento cardiorrespirat??rio
qualidade de vida
sleep disorders
obstructive sleep apnea
cardiorespiratory monitoring
quality of life
CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv sleep disorders
obstructive sleep apnea
cardiorespiratory monitoring
quality of life
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE
description Introduction: Sleep disorders are common all over the world and have profound effects on modern industrialized societies "24 hours". Obstructive sleep apnea (OSA) has a high morbidity and mortality, associated with a prevalence of 9.6% in women and 24.8% in men in the general population. OSA is more prevalent in chronic end-stage renal disease (CKD) and is associated with systemic arterial hypertension (SAH), left ventricular hypertrophy and increased mortality. Although OSA is characterized by repetitive collapse of the upper airway (VAS) during sleep, its cause is still not completely established. The observation that OSA is more prevalent in patients with edematous states, such as heart failure and ESRD than in the general population, raises the possibility that fluid retention may increase the risk of OSA. Objectives: To verify the behavior of the apnea/hypopnea index in the interdialytic period in patients with CKD. Methods: A consecutive cross-sectional clinical study was conducted to investigate the behavior of sleep apnea/hypopnea index (AHI) in patients with CKD undergoing HD at the Unidade de Nefrologia (UNEFRO) at Hospital Santa Casa de Miseric??rdia in Avar??, (SP) and Centro de Nefrologia Zona Norte - CENENORTE, S??o Paulo (SP), Brazil. The design and conduct of this study followed the guidelines of the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) statement. Results: In the first phase of the study, 243 patients were evaluated, with 61.32% of males, with a mean age of 57 years, presenting as baseline SAH (46.3%), DM (38.8% ), Glomeronephritis (4.7%) and other diseases (10.3%). In the second phase, 18 patients underwent home night time polygraphy at night after HD and two subsequent nights using a portable cardiorespiratory monitoring device Apnea Link Air (ResMed Corporation, San Diego, CA, USA). The clinical and demographic characteristics of the population involved in this study are very similar to those described in the literature, emphasizing the predominance of patients with SAH and DM as the underlying disease. In relation to excessive daytime sleepiness, a high prevalence was observed. When we analyzed the risk for OSA, a large number of patients with a high risk of apnea were observed through the Berlin clinical questionnaire. As for the quality of life, a commitment was observed in all aspects related to the physical and mental domains, showing a marked commitment. Preliminary data from the study with polygraphs showed that AHI showed a significant change in the interdialytic period, showing the influence of rostraine fluids on the magnitude of obstructive respiratory events during sleep. Conclusions: This important finding allows new investigations regarding the use of noninvasive ventilatory support during sleep in patients with CKD submitted to HD, which may improve sleep quality, as well as reduce cardiovascular risk, the main cause of morbidity and mortality in this population
publishDate 2016
dc.date.issued.fl_str_mv 2016-12-15
dc.date.accessioned.fl_str_mv 2018-07-16T21:25:37Z
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dc.identifier.citation.fl_str_mv Santos, Israel dos Reis dos. Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise. 2016. 68 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.
dc.identifier.uri.fl_str_mv http://bibliotecatede.uninove.br/handle/tede/1838
identifier_str_mv Santos, Israel dos Reis dos. Estudo do sono, risco de apneia, sonol??ncia excessiva diurna e qualidade de vida de pacientes com doen??a renal cr??nica submetidos ?? hemodi??lise. 2016. 68 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.
url http://bibliotecatede.uninove.br/handle/tede/1838
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dc.publisher.initials.fl_str_mv UNINOVE
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Sa??de
publisher.none.fl_str_mv Universidade Nove de Julho
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repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)
repository.mail.fl_str_mv bibliotecatede@uninove.br||bibliotecatede@uninove.br
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