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NDT Advance Access published online on August 12, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp403
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Prevalence of chronic kidney disease in patients with suspected sleep apnoea

Georg Fleischmann1, Gundula Fillafer1, Heike Matterer1, Falko Skrabal1 and Peter Kotanko1,2

1 Department of Internal Medicine, Krankenhaus der Barmherzigen Brüder, Graz, Austria 2 Renal Research Institute, New York, NY, USA

Correspondence and offprint requests to: Peter Kotanko; E-mail: pkotanko{at}rriny.com



  Abstract

Background. Little is known about the epidemiology of chronic kidney disease (CKD) in patients with suspected sleep apnoea (SA).

Methods. Glomerular filtration rate (eGFR) was calculated in consecutive patients referred for full-night observed in-hospital polysomnography. SA was defined as the respiratory disturbance index (RDI) > 5.

Results. One hundred and fifty-eight patients were studied. The age (mean ± SD) was 61.2 ± 12.7 years, body mass index 29.5 ± 5.9 kg/m2 and eGFR 86.1 ± 21.7 mL/min/1.73 m2. SA was present in 133 patients (85%). The eGFR was 94.6 7 mL/min/1.73 m2 in patients without SA and 84.5 7 mL/min/1.73 m2 in patients with SA [mean difference (95% confidence interval) 10.0 (0.6–19.4) mL/min/1.73 m2; P = 0.037]. Seventy patients had eGFR ≥ 90 mL/min/1.73 m2 (group 1), and 70 patients had between 60 and 89 mL/min/1.73 m2 (group 2), and 18 patients had 30–59 mL/min/1.73 m2 (CKD 3). Although the prevalence of SA did not differ among the groups (group 1: 80%; group 2: 86%; CKD 3: 94%), the number of central sleep apnoeas (CSA) per hour was 5.9 ± 12.2 in CKD 3, six times greater compared to patients with eGFR ≥ 60 mL/min/1.73 m2 (1.0 ± 2.1; P = 0.01). The prevalence of obstructive SA did not differ between the groups. After adjustment for age, gender, BMI, hypertension, diabetes mellitus and smoking status, CKD 3 (P = 0.0004) and New York Heart Association class ≥3 (P = 0.0001) remained predictive of CSA events per hour.

Conclusions. eGFR is reduced in patients with SA, particularly in those with episodes of CSA.

Keywords: cardiac insufficiency; central sleep apnoea; chronic kidney disease; CKD 3; sleep apnoea

Received for publication: 9. 3.09
Accepted in revised form: 16. 7.09


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