Kidney Week

Abstract: SA-PO0486

Sleep-Related Symptom Burden and Cardiac Rhythm Abnormalities in Patients with CKD and Obstructive Sleep Apnea

Session Information

• CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Nizami, Tarek, Brown University Health, Providence, Rhode Island, United States

Tarek Nizami, MD, MBBS

• Shringi, Sandipan, Brown University Health, Providence, Rhode Island, United States

Sandipan Shringi, MD, FASN

• Omara, AnnMarie, Brown University Health, Providence, Rhode Island, United States

AnnMarie Omara, RN

• Bhattarai, Shreeyukta, Brown University Health, Providence, Rhode Island, United States

Shreeyukta Bhattarai, MD

• Raker, Christina A., Brown University Health, Providence, Rhode Island, United States

Christina A. Raker, ScD

• Tang, Jie, Brown University Health, Providence, Rhode Island, United States

Jie Tang, MD, MS, MPH, FASN

Background

Obstructive sleep apnea (OSA) is highly prevalent in chronic kidney disease (CKD) and contributes to increased cardiovascular morbidity. The relationship between OSA, cardiac rhythm disturbances, and sleep-related symptom burden in CKD remains incompletely understood.

Methods

We conducted a cross-sectional analysis of a prospective CKD cohort. Among 105 enrolled patients, 83 completed baseline sleep studies and 78 had echocardiographic or electrocardiographic data available. OSA was defined using the apnea-hypopnea index (AHI). Cardiac abnormalities were assessed using electrocardiography and echocardiography. Sleep-related symptom burden was measured using the Epworth Sleepiness Scale (ESS). Adjusted logistic regression models included age, sex, race, BMI, and anti-hypertensive medication use.

Results

Among 83 participants (mean age 57.7±12.4 years; 53% male), 50 (60%) had OSA. Rhythm abnormalities were present in 24% and conduction abnormalities in 27% of patients. Cardiac abnormalities did not significantly differ by OSA status (Table 1). Among all patients, higher ESS scores were independently associated with rhythm abnormalities (adjusted OR 1.15, 95% CI 1.01–1.31; p=0.03), but not with conduction or structural abnormalities. Among patients with OSA, rhythm abnormalities were associated with higher ESS scores (median 11 [10–13] vs. 6 [2.5–8]; adjusted OR 1.29, 95% CI 1.05–1.59; p=0.02) (Table 2). AHI distributions did not differ by rhythm or conduction abnormalities.

Conclusion

In this CKD cohort, OSA was not associated with a higher prevalence of structural or electrical cardiac abnormalities. However, rhythm abnormalities were associated with greater sleep-related symptom burden, particularly among patients with OSA, suggesting a potential symptom-driven cardio-renal phenotype.

Acknowledgment

The authors acknowledge the study participants and the research staff involved in data collection and study coordination.

Funding

• Private Foundation Support