Sleep apnea is not associated with worse outcomes in kidney transplant recipients

被引:19
作者
Fornadi, Katalin [1 ]
Ronai, Katalin Zsuzsanna [2 ]
Turanyi, Csilla Zita [2 ]
Malavade, Tushar S. [3 ]
Shapiro, Colin Michael [2 ,4 ,5 ]
Novak, Marta [2 ,4 ]
Mucsi, Istvan [2 ,3 ,6 ]
Molnar, Miklos Z. [7 ]
机构
[1] Semmelweis Univ, Dept Neurol, H-1085 Budapest, Hungary
[2] Semmelweis Univ, Inst Behav Sci, H-1085 Budapest, Hungary
[3] Univ Toronto, Univ Hlth Network, Dept Med, Div Nephrol, Toronto, ON, Canada
[4] Univ Toronto, Univ Hlth Network, Dept Psychiat, Toronto, ON, Canada
[5] Univ Toronto, Univ Hlth Network, Dept Ophthalmol, Toronto, ON, Canada
[6] Semmelweis Univ, Inst Pathophysiol, H-1085 Budapest, Hungary
[7] Univ Tennessee, Ctr Hlth Sci, Dept Med, Div Nephrol, Memphis, TN 38163 USA
关键词
EXCESSIVE DAYTIME SLEEPINESS; THRICE-WEEKLY HEMODIALYSIS; STAGE RENAL-DISEASE; RISK-FACTOR; MATCHED CONTROLS; HYPERTENSION; MORTALITY; PREVALENCE;
D O I
10.1038/srep06987
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Obstructive sleep apnea(OSA) is one of the most common sleep disorders in kidney transplant recipients, however its long-term consequences have only rarely been investigated. Here, we hypothesized that the presence of OSA would be associated with higher risk of mortality and faster decline of graft function in kidney transplant recipients. In a prospective cohort study 100 prevalent kidney transplant recipients who underwent one-night polysomnography at baseline and were followed for a median 75 months. Generalized linear mixed-effects models and Cox regression models were used to assess the association between OSA and the rate of progression of chronic kidney disease(CKD) and mortality. The estimated slopes of estimated glomerular filtration rate(eGFR) in patients with and without OSA were compared using a two-stage model of eGFR change including only OSA as a variable. In this model patients with OSA (eGFR versus time was -0.93 ml/min/1.73 m(2)/yr(95% CI: -1.75 to -0.11) had a similar slope as compared to patients without OSA(eGFR versus time was -1.24 ml/min/1.73 m(2)/yr(95% CI: -1.67 to -0.81). In unadjusted Cox proportional regression analyses OSA was not associated with higher all-cause mortality risk (Hazard Ratio(HR) = 1.20; 95% Confidence Interval(CI): 0.50-2.85). No association was found between the presence of OSA and the rate of progression of CKD or all-cause mortality in prevalent kidney transplant recipients.
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页数:7
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共 37 条
[1]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[2]   Reliability of a questionnaire screening restless legs syndrome in patients on chronic dialysis [J].
Cirignotta, F ;
Mondini, S ;
Santoro, A ;
Ferrari, G ;
Gerardi, R ;
Buzzi, G .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2002, 40 (02) :302-306
[3]   Nocturnal Rostral Fluid Shift A Unifying Concept for the Pathogenesis of Obstructive and Central Sleep Apnea in Men With Heart Failure [J].
Dai Yumino ;
Redolfi, Stefania ;
Ruttanaumpawan, Pimon ;
Su, Mao-Chang ;
Smith, Stephanie ;
Newton, Gary E. ;
Mak, Susanna ;
Bradley, T. Douglas .
CIRCULATION, 2010, 121 (14) :1598-1605
[4]   Cardiovascular disease and health-care utilization in snorers: A population survey [J].
Dunai, Andrea ;
Keszei, Andras P. ;
Kopp, Maria S. ;
Shapiro, Colin M. ;
Mucsi, Istvan ;
Novak, Marta .
SLEEP, 2008, 31 (03) :411-416
[5]   Epworth Sleepiness Scale may be an indicator for blood pressure profile and prevalence of coronary artery disease and cerebrovascular disease in patients with obstructive sleep apnea [J].
Feng, Jing ;
He, Quan-ying ;
Zhang, Xi-long ;
Chen, Bao-yuan .
SLEEP AND BREATHING, 2012, 16 (01) :31-40
[6]   Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research [J].
Flemons, WW ;
Buysse, D ;
Redline, S ;
Pack, A ;
Strohl, K ;
Wheatley, J ;
Young, T ;
Douglas, N ;
Levy, P ;
McNicholas, W ;
Fleetham, J ;
White, D ;
Schmidt-Nowarra, W ;
Carley, D ;
Romaniuk, J .
SLEEP, 1999, 22 (05) :667-689
[7]   Relationship Between Overnight Rostral Fluid Shift and Obstructive Sleep Apnea in Drug-Resistant Hypertension [J].
Friedman, Oded ;
Bradley, T. Douglas ;
Chan, Christopher T. ;
Parkes, Robert ;
Logan, Alexander G. .
HYPERTENSION, 2010, 56 (06) :1077-1082
[8]   Sleep Disordered Breathing with Excessive Daytime Sleepiness is a Risk Factor for Mortality in Older Adults [J].
Gooneratne, Nalaka S. ;
Richards, Kathy C. ;
Joffe, Marshall ;
Lam, Regina W. ;
Pack, Fran ;
Staley, Bethany ;
Dinges, David F. ;
Pack, Allan I. .
SLEEP, 2011, 34 (04) :435-442
[9]   Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis [J].
Hanly, PJ ;
Pierratos, A .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (02) :102-107
[10]   Baseline comorbidity in kidney transplant recipients: A comparison of comorbidity indices [J].
Jassal, SV ;
Schaubel, DE ;
Fenton, SSA .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2005, 46 (01) :136-142