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Abstract: PO1116

CKD and Concomitant Sleep-Disordered Breathing Is Associated with Increased Overall Mortality: A Meta-Analysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Puthenpura, Max, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States
  • Hansrivijit, Panupong, UPMC Pinnacle, Harrisburg, Pennsylvania, United States
  • Ghahramani, Nasrollah, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Cheungpasitporn, Wisit, University of Mississippi Medical Center, Jackson, Mississippi, United States
Background

Sleep-disordered breathing (SDB) is common in advanced chronic kidney disease (CKD) patients. However, the association between CKD with concomitant SDB and overall mortality remains inconclusive. As it has been established that SDB and CKD individually contribute to overall mortality and that a large proportion of CKD patients have concommittant SDB, there comes a question if their morbid effects are compounded together.

Methods

Ovid MEDLINE, EMBASE, and the Cochrane Library were searched for eligible publications, including non-transplant CKD patients older than 18 years-old with co-existing SDB. CKD is defined in this study by estimated glomerular filtration rate of <60 mL/min/1.73m2.

Results

Seven observational studies (n = 186,686) were included in the meta-analyses. 94.2% of patients had end-stage kidney disease (ESKD) requiring hemodialysis (HD), 5.0% had ESKD requiring peritoneal dialysis (PD), and 0.8% had non-dialysis CKD. The mean patient age was 76.8 ± 2.2 years. Most patients were male (53.4%) and caucasian (76.8%). Up to 39.3% of patients had diabetes. The mean body mass index was 26.0 ± 0.6 kg/m2. Upon analysis, patients with advanced CKD and SDB demonstrated a pooled estimated odds ratios for overall mortality and cardiovascular events were 2.092 (95% CI, 1.594-2.744) and 1.020 (95% CI, 0.929-1.119), respectively compared to patients with CKD alone. No potential publication bias was detected. There were no significant differences in odds ratios for overall mortality, based on subgroup analyses.

Conclusion

Co-existence between advanced CKD and SDB is associated with significantly increased overall mortality, but not cardiovascular (CV) events when compared with CKD alone. The analysis of CV events requires additional studies to corroborate these findings. Moreover, these results suggest clinical interventions should be aimed to prevent the progression of SDB and CKD to mitigate the mortality associated in patients with both diseases.