Association of Sleep Apnea with Mortality in Patients with Advanced Kidney Disease
| Autor: | Manisha Jhamb, Surui Hou, Maria-Eleni Roumelioti, Hossam Abdalla, Herbert Davis, Jonathan G. Yabes, Mark Unruh, Sanjay R. Patel, Xinhui Ran |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Epidemiology Polysomnography Population Critical Care and Intensive Care Medicine National Death Index Risk Assessment Risk Factors Internal medicine Medicine Humans Prospective Studies Renal Insufficiency Chronic education Lung Aged Transplantation education.field_of_study Sleep Apnea Obstructive medicine.diagnostic_test business.industry Respiration Hazard ratio Sleep apnea Original Articles Middle Aged medicine.disease Prognosis respiratory tract diseases Apnea–hypopnea index Nephrology Kidney Failure Chronic Female business Sleep Body mass index Kidney disease |
| Zdroj: | Clin J Am Soc Nephrol |
| ISSN: | 1555-905X |
| Popis: | BACKGROUND AND OBJECTIVES: In the general population, sleep disorders are associated with mortality. However, such evidence in patients with CKD and ESKD is limited and shows conflicting results. Our aim was to examine the association of sleep apnea with mortality among patients with CKD and ESKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this prospective cohort study, 180 patients (88 with CKD stage 4 or 5, 92 with ESKD) underwent in-home polysomnography, and sleep apnea measures such as apnea hypopnea index (AHI) and nocturnal hypoxemia were obtained. Mortality data were obtained from the National Death Index. Cox proportional hazard models were used for survival analysis. RESULTS: Among the 180 patients (mean age 54 years, 37% women, 39% with diabetes, 49% CKD with mean eGFR 18±7 ml/min per 1.73 m(2)), 71% had sleep apnea (AHI>5) and 23% had severe sleep apnea (AHI>30). Median AHI was 13 (range, 4–29) and was not significantly different in patients with advanced CKD or ESKD. Over a median follow-up of 9 years, there were 84 (47%) deaths. AHI was not significantly associated with mortality after adjusting for age, sex, race, diabetes, body mass index, CKD/ESKD status, and kidney transplant status (AHI>30: hazard ratio [HR], 1.5; 95% confidence interval [95% CI], 0.6 to 4.0; AHI >15 to 30: HR, 2.3; 95% CI, 0.9 to 5.9; AHI >5 to 15: HR, 2.1; 95% CI, 0.8 to 5.4, compared with AHI≤5). Higher proportion of sleep time with oxygen saturation |
| Databáze: | OpenAIRE |
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