title: Nonapnea sleep disorders and incident chronic kidney disease: a population-based retrospective cohort study.
abstract: Nonapnea sleep disorders (NASDs) are associated with an increased risk of stroke, diabetes, and hypertension. No longitudinal study has yet examined the association between NASD and chronic kidney disease (CKD) by using epidemiologic study methods. To test this hypothesis, we examined the effect of NASD on the incidence of CKD in a large population-based retrospective cohort study. Based on a retrospective cohort study of a general population sample of 128 to 436 patients in the Taiwan National Health Insurance Research Database from January 1, 1998 to December 31, 2001, 42 to 812 NASD patients were followed up for 10.2 ± 3.12 years, and additional 85 to 624 individuals had no NASD at baseline. The International Classification of Diseases, Ninth Revision, Clinical Modification was used to identify the diagnosis of disease. Cox proportional hazard regression models were used to assess the association between NASD and subsequent CKD risk. The incidence rate of CKD was significantly higher in the NASD cohort than in the comparison cohort (2.68 vs 1.88 per 1000 person-years, respectively). After we adjusted for age, sex, and comorbidities, the risk of developing CKD was significant for patients with NASD (adjusted hazard ratio [HR] = 1.13; 95% confidence interval [CI] = 1.05-1.22; P < 0.01). Among different types of NASDs, patients with sleep disturbance associated disorders had a 14% increased risk of developing CKD (95% CI = 1.03-1.26; P < 0.01), whereas patients with insomnia had a 13% increased risk of subsequent CKD (95% CI = 1.02-1.25; P < 0.05) compared with the non-NASD cohort. Kaplan-Meier survival analysis indicated that the CKD-free rate was 1% lower in the NASD cohort than in the comparison cohort (log-rank test, P < 0.0001). Our study provides evidence that patients with NASD have an increased risk of developing subsequent CKD compared with patients without NASD; men, elderly people, and patients with concomitant comorbidities are at the greatest risk.
authors: From the Division of Nephrology (S-TH, T-MY), Department of Medicine, Taichung Veterans General Hospital; Graduate Institute of Clinical Medicine Science (S-TH, T-MY), School of Medicine, College of Medicine, China Medical University; Management Office for Health Data (C-LL), China Medical University Hospital; College of Medicine (C-LL), China Medical University; Division of Nephrology (T-CY), Department of Internal Medicine, Kuang-Tien General Hospital; School of Medicine (C-HK), China Medical University; Department of Nuclear Medicine and PET Center (C-HK), China Medical University Hospital, Taichung, Taiwan.
authors: Shih-Ting
authors: ST
authors: Huang
authors: Cheng-Li
authors: CL
authors: Lin
authors: Tung-Min
authors: TM
authors: Yu
authors: Te-Cheng
authors: TC
authors: Yang
authors: Chia-Hung
authors: CH
authors: Kao
mesh_terms: D000367:Age Factors; D016022:Case-Control Studies; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012189:Retrospective Studies; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D020521:Stroke / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology
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