title: Simple obstructive sleep apnea patients without hypertension or diabetes accelerate kidney dysfunction: a population follow-up cohort study from Taiwan.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is common in patients on hemodialysis, but its correlation with chronic kidney disease (CKD) is not clear. We aimed to clarify the relationship between OSA without hypertension or diabetes and incidence of CKD in Taiwan.
  
  
  METHODS
  This population-based cohort study consisted of patients with newly diagnosed OSA between 2000 and 2009. The comparison cohort was matched for age, sex, diabetes mellitus, and hypertension. All subjects previously diagnosed with acute or chronic kidney disease were excluded. The primary end point was newly diagnosed CKD.
  
  
  RESULTS
  We identified 6866 subjects with OSA during the 10-year study period. The median duration until development of CKD in the OSA cohort was 3.2 years, 2.5 months earlier than that in the non-OSA cohort. After exclusion of hypertension and diabetes, 4319 OSA patients was identified and the hazard ratio (HR) of CKD with OSA was 1.37 (95 % confidence interval [CI], 1.05-1.77; p = 0.019). In the subgroup analysis, an increased incidence of CKD in OSA was observed in women (HR, 1.41; 95 % CI, 1.12-1.78; p = 0.0036).
  
  
  CONCLUSIONS
  This longitudinal population-based cohort study provides evidence that patients with OSA even without diabetes or hypertension are at higher risk of developing CKD over the next 3 years and nearly 2.5 months earlier than the non-OSA cohort, particularly women.
authors.affiliation: Department of Cardiology, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.|Healthcare Center, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.|Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lin
authors.affiliation: Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Pi-Hua
authors.initials: PH
authors.lastname: Liu
authors.affiliation: Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu RD., Guishan Township, Taoyuan County, Taiwan, Republic of China.
authors.forename: Shi-Wei
authors.initials: SW
authors.lastname: Lin
authors.affiliation: Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu RD., Guishan Township, Taoyuan County, Taiwan, Republic of China.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Li-Pang
authors.initials: LP
authors.lastname: Chuang
authors.affiliation: Department of Cardiology, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.
authors.forename: Wan-Jing
authors.initials: WJ
authors.lastname: Ho
authors.affiliation: Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu RD., Guishan Township, Taoyuan County, Taiwan, Republic of China.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Chou
authors.affiliation: Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Kuo-Chang
authors.initials: KC
authors.lastname: Juan
authors.affiliation: Department of Radiology, University of California, San Diego, USA.
authors.forename: Min-Tzu
authors.initials: MT
authors.lastname: Lo
authors.affiliation: Department of Cardiology, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.|Healthcare Center, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.|Heart Failure Center, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.
authors.forename: Pao-Hsien
authors.initials: PH
authors.lastname: Chu
authors.affiliation: Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu RD., Guishan Township, Taoyuan County, Taiwan, Republic of China. ninghung@yahoo.com.tw.
authors.forename: Ning-Hung
authors.initials: NH
authors.lastname: Chen
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000503:physiopathology*; D007677:Kidney Function Tests; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D013223:Statistics as Topic; D013624:Taiwan; D055815:Young Adult
keywords: Diabetes; Hypertension; Kidney dysfunction; Obstructive sleep apnea