Sleep Apnea Severity and Mortality in CKD and ESRD Patients

Austin, Texas—The association between sleep apnea and mortality is well established in the general population; there are few data on this association in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Hossam Abdalla, MD, and colleagues conducted a study designed to examine the association between the severity of sleep apnea and mortality in patients with advanced CKD and ESRD.

Results of the study were reported during a poster session at the NKF 2018 Spring Clinical Meetings. The poster was titled Association of Sleep Apnea with Mortality in Chronic and End-Stage Kidney Disease Patients.

The study cohort included 180 patients: 87 with CKD stage 4-5 and 93 with ESRD. The participants underwent 1 night of at-home polysommography. The apnea hypopnea index (AHI) was used to assess severity of sleep apnea. Patient interviews and chart reviews were used to obtain patients’ demographics, comorbidities, and laboratory values. The National Death index yielded data on mortality data through December 31, 2016.

Transplant status was gathered from chart review. Between-group differences were tested using Chi-square and ANOVA; Cox proportional hazard model was used to test the association of sleep apnea with mortality.

Among the 180 patients, mean age was 53.9 years, 62.8% were men, 65.6% were white, 38.8% had diabetes, 51.1% had ESRD, and 48.9% had CKD. Overall, 71% had sleep apnea, defined as AHI ≥5, and 23% had severe sleep apnea, defined as >30 AHI.

Mean follow-up was 9.37 years. During the follow-up period, there were 31 deaths and 60 kidney transplants. In unadjusted analysis and in analyses adjusted for age, sex, race, diabetes, kidney transplant status, and CKD versus ESRD, there was no association between severity of sleep apnea and all-cause mortality.

The researchers said, “Our study shows that sleep apnea severity is not associated with increased mortality in advanced chronic and end-stage kidney disease patients.”

Source: Abdalla H, Yabes J, Hou S, et al. Association of sleep apnea with mortality in chronic and end-stage kidney disease patients. Abstract of a poster presented at the National Kidney Foundation 2018 Spring Clinical Meetings, April 10-14, 2018, Austin, Texas.