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NDT Advance Access originally published online on June 7, 2007
Nephrology Dialysis Transplantation 2007 22(10):3028-3033; doi:10.1093/ndt/gfm309
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org


Impact of kidney transplantation on sleep apnoea in patients with end-stage renal disease

Jaime M. Beecroft1, Jeffrey Zaltzman2, Ramesh Prasad2, Galo Meliton2 and Patrick J. Hanly1

1Department of Medicine, University of Calgary, Alberta and 2Department of Medicine, University of Toronto, Ontario, Canada

Correspondence and offprint requests to: Patrick J. Hanly, 1421 Health Sciences Center, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1. Email: phanly{at}ucalgary.ca



  Abstract

Background. Sleep apnoea is common in patients with end-stage renal disease. Although individual case reports have described an improvement in sleep apnoea following kidney transplantation, there have been no longitudinal studies of a case series to determine what proportion of patients with sleep apnoea improve.

Methods. Dialysis-dependent patients awaiting kidney transplantation and pre-dialysis patients with an identified living donor kidney had overnight polysomnography, which was repeated several months after successful kidney transplantation. Patients were divided into apnoeic and non-apnoeic groups based on an apneoa-hypopnoea index (AHI) > 10/h during pre-transplant polysomnography and, following transplantation, apnoeic patients were further divided into responders and non-responders based on >50% reduction in AHI and/or AHI < 10/h.

Results. Eighteen patients (11 men, 7 women), aged 27–65, were studied. Pre-transplant sleep apnoea was present in 11 of 18 (61%) patients. Although transplantation was associated with a significant reduction in blood urea nitrogen and serum creatinine, there were no significant changes in AHI (pre vs post: 20.2 ± 15.1 vs 23.5 ± 21.3). Among the 11 apnoeic patients, only three met the criteria for a significant improvement (‘responder’). There were no patient characteristics, sleep apnoea indices or renal function changes that distinguished responders from non-responders.

Conclusions. Sleep apnoea improves in a minority of patients with end-stage renal disease following successful kidney transplantation. Specific determinants of improvement were not identified.

Keywords: end-stage renal disease; kidney transplantation; polysomnography; sleep apnoea; sleep-disordered breathing

Received for publication: 21.12.06
Accepted in revised form: 24. 4.07


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