Article

Sleep-disordered breathing in nondialyzed patients with chronic renal failure

Department of Pulmonary Medicine, A Fleming General Hospital, 2 Pigis St., 15126, Mellisia, Athens, Greece.
Beiträge zur Klinik der Tuberkulose (Impact Factor: 2.17). 02/2006; 184(1):43-9. DOI: 10.1007/s00408-005-2563-2
Source: PubMed

ABSTRACT The prevalence and significance of sleep-disordered breathing (SDB) in dialysis-independent chronic renal failure (CRF) remains unknown. We studied the presence of SDB in nondialyzed CRF patients. Diagnostic polysomnography was performed in consecutive stable nondialyzed CRF patients. Inclusion criteria were age <or=70 years, absence of systolic dysfunction or history of pulmonary edema, FEV(1) > 70% pr, absence of neurologic disease or hypothyroidism, and calculated creatinine clearance <40 ml/min. Thirty-five patients (19 male, 16 female) were studied. An apnea-hypopnea index (AHI) >or=5/h was present in 54.3% (almost exclusively obstructive events). AHI correlated with urea (r = 0.35, p = 0.037), age (r = 0.379, p = 0.025), and body mass index (BMI) (r = 0.351, p = 0.038), but not with creatinine clearance. AHI or SDB were unrelated to gender. In nondiabetics (n = 25), AHI correlated with urea (r = 0.608, p = 0.001) and creatinine clearance (r = -0.50, p = 0.012). Nondiabetics with severe CRF (calculated GFR < 15 ml/min/1.73 m(2)) had a significantly higher AHI compared with less severe CRF. Restless legs syndrome (RLS) was present in 37.1% and periodic limb movements in 28.6%. Daytime sleepiness was not associated with respiratory events, but was more common in patients with RLS. The prevalence of SDB and RLS is high in dialysis-independent CRF. SDB weakly correlates with indices of kidney function and this association becomes stronger in nondiabetics.

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    • "In addition, it has been reported that over 50% of patients with severe CKD, who do not require dialysis, have mild SDB [9]. However, most of these investigations are limited by small sample sizes with no comparison group or lack of applicability to patients with mild renal disease [9] [10]. To our knowledge, no prior study has evaluated the association between mild to moderate impairments in renal function and SDB in community-dwelling older adults. "
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