title: Sleep-Disordered Breathing in Patients with Polycystic Liver and Kidney Disease Referred for Transcatheter Arterial Embolization.
abstract: OBJECTIVE
  Sleep-disordered breathing (SDB) is prevalent among patients with CKD, but its prevalence among patients with symptomatic autosomal dominant polycystic kidney disease (ADPKD) and its association with total liver and kidney volume remain unclear.
  
  
  METHODS
  This study examined the association between height-adjusted total liver and kidney volume (htTLKV) and SDB in a cross-sectional study of 304 adult patients with symptomatic ADPKD who were hospitalized at Toranomon Hospital for transcatheter arterial embolization and who underwent pulse oximetry between April 2008 and November 2013. SDB was defined as having a 3% oxygen desaturation index of ≥15 events per hour of sleep. Logistic regression was performed with sex-specific quartiles of htTLKV as the main predictor, using patient data and comorbidities as covariates.
  
  
  RESULTS
  Overall (54.6% women, mean age 56.2±9.4 years, 83.5% on hemodialysis), 177 of 304 patients (58.2%) had SDB. SDB was strongly associated with htTLKV quartiles, demonstrating that odds ratios (ORs) and 95% confidence intervals (95% CIs) for SDB were 1.63 (0.76 to 3.48), 2.35 (1.09 to 5.06), and 4.61 (1.98 to 10.7) for htTLKV quartiles 2-4 (P for trend, P=0.003), respectively. Older age (OR, 1.81 per 10 years; 95% CI, 1.29 to 2.55), male sex (OR, 3.87; 95% CI, 1.96 to 7.66), receiving hemodialysis (OR, 3.46; 95% CI, 1.62 to 12.1), and higher body mass index (≥25 kg/m(2)) (OR, 3.03; 95% CI, 1.08 to 8.52) were also associated with SDB.
  
  
  CONCLUSIONS
  In this highly selected population of patients with symptomatic ADPKD referred for transcatheter arterial embolization, SDB was highly prevalent and independently associated with higher htTLKV.
authors.affiliation: Nephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Nephrology Center and k-sumida@umin.ac.jp.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sumida
authors.affiliation: Nephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Nephrology Center and.
authors.forename: Junichi
authors.initials: J
authors.lastname: Hoshino
authors.affiliation: Nephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Nephrology Center and.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suwabe
authors.affiliation: Sleep Center, Toranomon Hospital, Tokyo, Japan; and Departments of Cardiology and Cardio-Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.affiliation: Nephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Nephrology Center and.
authors.forename: Noriko
authors.initials: N
authors.lastname: Hayami
authors.affiliation: Nephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan;
authors.forename: Koki
authors.initials: K
authors.lastname: Mise
authors.affiliation: Nephrology Center and.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawada
authors.affiliation: Nephrology Center and.
authors.forename: Aya
authors.initials: A
authors.lastname: Imafuku
authors.affiliation: Nephrology Center and.
authors.forename: Rikako
authors.initials: R
authors.lastname: Hiramatsu
authors.affiliation: Nephrology Center and.
authors.forename: Eiko
authors.initials: E
authors.lastname: Hasegawa
authors.affiliation: Nephrology Center and.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamanouchi
authors.affiliation: Nephrology Center and.
authors.forename: Naoki
authors.initials: N
authors.lastname: Sawa
authors.affiliation: Sleep Center, Toranomon Hospital, Tokyo, Japan; and.
authors.forename: Koji
authors.initials: K
authors.lastname: Narui
authors.affiliation: Nephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Nephrology Center and.
authors.forename: Kenmei
authors.initials: K
authors.lastname: Takaichi
authors.affiliation: Nephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan; Nephrology Center and.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ubara
mesh_terms: D000368:Aged; D001827:Body Height; D003430:Cross-Sectional Studies; D003560:Cysts / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000473:pathology; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009929:Organ Size; D010092:Oximetry; D016891:Polycystic Kidney, Autosomal Dominant / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence; D012017:Referral and Consultation; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*
keywords: CKD; autosomal dominant polycystic kidney disease; hypoxia
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