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Frequency and predictors of obstructive sleep apnea in patients with chronic kidney disease
Recent evidence suggests that obstructive sleep apnea (OSA) is common in patients with chronic kidney disease (CKD) and may accelerate the loss of renal function. The AOS has been related to increased oxidative stress, endothelial dysfunction and inflammatory states, which are known mechanisms of renal injury.
To evaluate the frequency and predictors of OSA in patients with non-dialytic CKD.
This is an observational cross-sectional, analytical study. We evaluated 79 patients with non-dialytic CKD, glomerular filtration rate (GFR) <60mL / min / 1.73m2, age between 30 and 64 years. All patients underwent a clinical evaluation, sleep questionnaires (Berlin questionnaire and Epworth sleepiness scale) and portable polysomnography for diagnosis of OSA (apnea and hypopnea index – AHI ≥ 5 e / h).
Results: OSA was diagnosed in 65 patients (82%, 95% CI: 73-90%). Mild OSA (AHI ≥ 5 e / h) and moderate / severe OSA (AHI ≥ 15 e / h) was present in 26 (33%, 95% CI: 23-43%) and 39 (49%, 95% CI: 38-60%) patients, respectively. The Berlin questionnaire presented low sensitivity and specificity (58% and 47%, respectively) as an AOS predictor (AHI ≥ 5 e / h) in this population and the severity of OSA was not associated with daytime sleepiness. A logistic regression for the determination of OSA predictors in this population found in the multivariate analysis that age> 50 years (OR = 7.8; CI: 1.2 - 50.7; P = 0.03), male sex (OR = 4.6; CI: 1.4 – 15,1; P = 0.01), and body mass index (BMI) - (OR = 1,3; CI: 1.1 -1,5 ; P=0.001) were independently associated with OSA.
Conclusion: OSA is common in patients with non-dialytic CKD. Advanced age, male gender and elevated BMI are predictors of OSA in this population. Sleep questionnaires should be interpreted with caution in these patients.
Obstructive sleep apnea, Chronic kidney disease, Risk Factors
Pronto Socorro Cardiológico de Pernambuco - Pernambuco - Brasil
Tarcya L. G. Couto Patriota, Maria Helena A Gerônimo, Luiz A P Oliveira Neto, Valeska K Rodrigues, Thaís C L Mattos, Jéssica A Magalhães, Marcus V F P Silva, Rodrigo L S Patriota, Edmir B R Dias Filho, Rodrigo P Pedrosa