Sleep-disordered breathing in nondialyzed patients with chronic renal failure

• Published in: Lung Vol. 184; no. 1; pp. 43 - 49
• Main Authors: Markou, Nikolaos, Kanakaki, Maria, Myrianthefs, Pavlos, Hadjiyanakos, Dimitrios, Vlassopoulos, Dimosthenis, Damianos, Anastasios, Siamopoulos, Konstantinos, Vasiliou, Miltiadis, Konstantopoulos, Stavros
• Format: Journal Article
• Language: English
• Published: United States Springer 01-02-2006; Springer Nature B.V
• Subjects: Age Factors; Apnea; Body mass; Body Mass Index; Body size; Breathing; Care and treatment; Chronic kidney failure; Correlation; Creatinine; Creatinine - analysis; Diabetic Nephropathies - complications; Diagnosis; Dialysis; Edema; Female; Hemodialysis; Humans; Hypothyroidism; Kidney diseases; Kidney Failure, Chronic - complications; Lung diseases, Obstructive; Male; Mathematical analysis; Middle Aged; Neurological diseases; Polysomnography; Prospective Studies; Renal failure; Respiration; Respiratory system; Restless legs syndrome; Restless Legs Syndrome - complications; Risk factors; Severity of Illness Index; Sleep; Sleep and wakefulness; Sleep apnea syndromes; Sleep Apnea Syndromes - complications; Sleep deprivation; Sleep disorders; Sleepiness; Urea; Urea - analysis
• ISSN: 0341-2040; 1432-1750
• DOI: 10.1007/s00408-005-2563-2

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.