title: Sleep apnea and the risk of chronic kidney disease: a nationwide population-based cohort study.
abstract: OBJECTIVE
  Sleep apnea (SA) is characterized by apnea during sleep and is associated with cardiovascular diseases and an increase in all-cause mortality. Chronic kidney disease (CKD) is a global health problem that has placed a substantial burden on healthcare resources. However, the relationship between SA and the incidence of CKD is not clear. This study aimed to determine whether SA is an independent risk factor for the development of CKD.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  National Health Insurance Research Database (NHIRD) of Taiwan.
  
  
  METHODS
  A total of 4,674 adult patients (age ≥ 30 y) in whom SA was newly diagnosed from 2000 to 2010 were included, together with 23,370 non-SA patients as the comparison group. The two groups were frequency-matched for sex, age, and year of receiving medical service. Each individual was followed until 2011.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  These two groups were monitored and observed for the occurrence of CKD. Patients with SA experienced a 1.94-fold increase (95% confidence interval [CI], 1.52-2.46; P < 0.001) in the incidence of CKD, which was independent of sex, age, and comorbid medical conditions. Additionally, they showed a 2.2-fold increase (95% CI, 1.31-3.69; P < 0.01) in the incidence of end-stage renal disease (ESRD).
  
  
  CONCLUSIONS
  Patients with sleep apnea are at increased risk for chronic kidney disease and end-stage renal disease compared with the general population. As such, screening renal function and treatment of chronic kidney disease is an important issue in patients with sleep apnea.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.|Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yi-Che
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Shih-Yuan
authors.initials: SY
authors.lastname: Hung
authors.affiliation: Department of Neurosurgery, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.|Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Hao-Kuang
authors.initials: HK
authors.lastname: Wang
authors.affiliation: Department of Medical Education, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Chi-Wei
authors.initials: CW
authors.lastname: Lin
authors.affiliation: Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Hsi-Hao
authors.initials: HH
authors.lastname: Wang
authors.affiliation: Department of Family Medicine, Hsinchu Cathay General Hospital, Hsinchu, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Min-Yu
authors.initials: MY
authors.lastname: Chang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.|Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Li-Chun
authors.initials: LC
authors.lastname: Ho
authors.affiliation: Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Medicine, Hsin-Jen Hospital, New Taipei City, Taiwan.
authors.forename: Hung-Hsiang
authors.initials: HH
authors.lastname: Liou
authors.affiliation: Department of Pediatrics, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Tsuen-Chiuan
authors.initials: TC
authors.lastname: Tsai
authors.affiliation: Hong-En Clinic, Kaohsiung, Taiwan.
authors.forename: Shih-Hann
authors.initials: SH
authors.lastname: Tseng
authors.affiliation: Biostatistics Consulting Center, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Wang
authors.affiliation: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Sheng-Hsiang
authors.initials: SH
authors.lastname: Lin
authors.affiliation: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Yuan-Yow
authors.initials: YY
authors.lastname: Chiou
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D013624:Taiwan / Q000453:epidemiology
keywords: National Health Insurance; chronic kidney disease; cohort study; end-stage renal disease; sleep apnea