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Abstract: PO2050

High Prevalence of Sleep Disordered Breathing and Its Association with Renal Function in Patients with CKD: A Cross-Sectional Study

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Ota, Kanji, Division of Nephrology,Department of Medicine,Kurume University, Kurume, Fukuoka, Japan
  • Nakayama, Yosuke, Division of Nephrology,Department of Medicine,Kurume University, Kurume, Fukuoka, Japan
  • Moriyama, Tomofumi, Division of Nephrology,Department of Medicine,Kurume University, Kurume, Fukuoka, Japan
  • Kaida, Yusuke, Division of Nephrology,Department of Medicine,Kurume University, Kurume, Fukuoka, Japan
  • Fukami, Kei, Division of Nephrology,Department of Medicine,Kurume University, Kurume, Fukuoka, Japan
Background

Sleep disordered breathing (SBD) is known as a novel risk factor for cardiovascular disease, and one of five adults suffer from SBD in general population. In non-dialysis chronic kidney disease (CKD) and hemodialysis (HD) patients, a high prevalence of SBD has been reported due to the excess accumulation of extracellular fluid. However, precise prevalence and associated factors of SBD in patients with peritoneal dialysis (PD) has not been known. This cross-sectional study aimed to investigate the prevalence and determinant factors associated with SBD in patients with CKD.

Methods

This was a single-center retrospective cohort study recruited 334 patients with CKD stages 1-3a, 3b-5, HD, and PD enrolled from 2018 to 2020. All patients were hospitalized and received our CKD educational program, and did not have sleep complaints. The diagnosis and assessment of the severity of SBD were evaluated using PULSOX-Me300 and SAS2100 systems. The 3% oxygen desaturation index and SpO2 were measured during sleep. SBD was defined as 3% oxygen desaturation index (ODI)>15.0 and SpO2<92% in this study.

Results

Proportion of the patients with CKD1-3a, CKD3b-5, HD, and PD were 28%, 53%, 11%, and 8%, respectively. 31% of the patients were diagnosed with SBD in all CKD patients. In a generalized linear model, 3% ODI>15.0 and SpO2<92% were significantly correlated with apnea hypopnea index (p<0.05, r=0.87 and p<0.05, r=-0.45, respectively). Further, it became clear that the proportion of 3%ODI>15 and SpO2<92% was significantly higher in PD patients (50%) than in other CKD patients. Furthermore, 3% ODI was significantly correlated with BMI and HDL cholesterol levels in PD patients (p<0.05, r=0.67 and p<0.05, r=-0.54, respectively).

Conclusion

We reported for the first time that the prevalence of SBD was very high and that the severity of SBD was significantly associated with BMI in patients with PD. These findings suggest that the extracellular fluid overload and excess glucose exposure due to PD fluid might accelerate SBD in patients with PD. Further clinical studies are needed to determine whether PD-associated SBD might influence the development of cardiovascular disease in CKD patients.