Sleep apnea is not associated with worse outcomes in kidney transplant recipients.
Obstructive sleep apnea(OSA) is one of the most common sleep disorders in kidney transplant recipients, however its long-term consequences have only rarely been investigated. Here, we hypothesized that the presence of OSA would be associated with higher risk of mortality and faster decline of graft function in kidney transplant recipients. In a prospective cohort study 100 prevalent kidney transplant recipients who underwent one-night polysomnography at baseline and were followed for a median 75 months. Generalized linear mixed-effects models and Cox regression models were used to assess the association between OSA and the rate of progression of chronic kidney disease(CKD) and mortality. The estimated slopes of estimated glomerular filtration rate(eGFR) in patients with and without OSA were compared using a two-stage model of eGFR change including only OSA as a variable. In this model patients with OSA (eGFR versus time was -0.93 ml/min/1.73 m(2)/yr(95%CI:-1.75 to-0.11) had a similar slope as compared to patients without OSA(eGFR versus time was -1.24 ml/min/1.73 m(2)/yr(95%CI: -1.67 to -0.81). In unadjusted Cox proportional regression analyses OSA was not associated with higher all-cause mortality risk (Hazard Ratio(HR) = 1.20; 95% Confidence Interval(CI): 0.50-2.85). No association was found between the presence of OSA and the rate of progression of CKD or all-cause mortality in prevalent kidney transplant recipients.
Dept. of Neurology, Semmelweis University, Budapest, Hungary.
Katalin
K
Fornadi
Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
Katalin Zsuzsanna
KZ
Ronai
Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
Csilla Zita
CZ
Turanyi
Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada.
Tushar S
TS
Malavade
1] Dept. of Psychiatry, University Health Network, University of Toronto, Toronto, Canada [2] Dept. of Ophthalmology, University Health Network, University of Toronto, Toronto, Canada.
Colin Michael
CM
Shapiro
1] Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary [2] Dept. of Psychiatry, University Health Network, University of Toronto, Toronto, Canada.
Marta
M
Novak
1] Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary [2] Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada [3] Institute of Pathophysiology, Semmelweis University, Budapest, Hungary.
Istvan
I
Mucsi
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States.
Miklos Z
MZ
Molnar
D000328:Adult; D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D066027:Transplant Recipients; D016896:Treatment Outcome