title: Sleep-disordered breathing in nondialyzed patients with chronic renal failure.
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.
authors.affiliation: Department of Pulmonary Medicine, A Fleming General Hospital, 2 Pigis St., 15126, Mellisia, Athens, Greece. nikolaos_markou@hotmail.com
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Markou
authors.forename: Maria
authors.initials: M
authors.lastname: Kanakaki
authors.forename: Pavlos
authors.initials: P
authors.lastname: Myrianthefs
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Hadjiyanakos
authors.forename: Dimosthenis
authors.initials: D
authors.lastname: Vlassopoulos
authors.forename: Anastasios
authors.initials: A
authors.lastname: Damianos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Siamopoulos
authors.forename: Miltiadis
authors.initials: M
authors.lastname: Vasiliou
authors.forename: Stavros
authors.initials: S
authors.lastname: Konstantopoulos
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D003404:Creatinine / Q000032:analysis; D003928:Diabetic Nephropathies / Q000150:complications*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D012148:Restless Legs Syndrome / Q000150:complications; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000150:complications*; D014508:Urea / Q000032:analysis
chemical_list: D014508:Urea; D003404:Creatinine