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Chronic kidney disease in European patients with obstructive sleep apnea: the ESADA cohort study

Journal article
Authors Oreste Marrone
Salvatore Battaglia
Paschalis Steiropoulos
Ozen K. Basoglu
John A. Kvamme
Silke Ryan
Jean Louis Pepin
Johan Verbraecken
Ludger Grote
Jan A Hedner
Maria R. Bonsignore
Ulla Anttalainen
Tarja Saaresranta
Ferran Barbé
Sezai Tasbakan
Piotr Bielicki
Marta Kumor
Rio Dumitrascu
Richard Schulz
Pierre Escourrou
Gabriel Roisman
Ingo Fietze
Thomas Penzel
Brian D. Kent
Walter T. McNicholas
Patrick Lévy
Jean Louis Pépin
Renaud Tamisier
Lena Lavie
Peretz Lavie
Carolina Lombardi
Gianfranco Parati
Juan Fernando Masa
Josep M. Montserrat
Athanasia Pataka
Robert Plywaczewski
Pawel Sliwinski
Martin Pretl
Renata Riha
Daniel Rodenstein
Ruzena Tkacova
Giedvar Varoneckas
Heleen Vrints
Audrey Vitols
Published in Journal of Sleep Research
Volume 25
Pages 739-745
ISSN 0962-1105
Publication year 2016
Published at Institute of Medicine
Pages 739-745
Language en
Keywords epidemiology, hypoxia, nephropathy
Subject categories Kidney diseases, Epidemiology

Abstract

© 2016 European Sleep Research Society The cross-sectional relationship of obstructive sleep apnea with moderate to severe chronic kidney disease, defined as an estimated glomerular filtration rate <60 mL min−1∙1.73 m−2, was investigated in a large cohort of patients with suspected obstructive sleep apnea studied by nocturnal polysomnography or cardiorespiratory polygraphy. Data were obtained from the European Sleep Apnea Database, where information from unselected adult patients with suspected obstructive sleep apnea afferent to 26 European sleep centres had been prospectively collected. Both the Modification of Diet in Renal Disease and the Chronic Kidney Disease-Epidemiology Collaboration equations were used for the assessment of estimated glomerular filtration rate. The analysed sample included 7700 subjects, 71% male, aged 51.9 ± 12.5 years. Severe obstructive sleep apnea (apnea–hypopnea index ≥30) was found in 34% of subjects. The lowest nocturnal oxygen saturation was 81 ± 10.2%. Chronic kidney disease prevalence in the whole sample was 8.7% or 6.1%, according to the Modification of Diet in Renal Disease or the Chronic Kidney Disease-Epidemiology Collaboration equations, respectively. Subjects with lower estimated glomerular filtration rate were older, more obese, more often female, had worse obstructive sleep apnea and more co-morbidities (P < 0.001, each). With both equations, independent predictors of estimated glomerular filtration rate <60 were: chronic heart failure; female gender; systemic hypertension; older age; higher body mass index; and worse lowest nocturnal oxygen saturation. It was concluded that in obstructive sleep apnea, chronic kidney disease is largely predicted by co-morbidities and anthropometric characteristics. In addition, severe nocturnal hypoxaemia, even for only a small part of the night, may play an important role as a risk factor for kidney dysfunction.

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