Relationship Between Obstructive Sleep Apnea (OSA) And Chronic Kidney Disease (CKD)

Robert Adams, Sarah Appleton, Andrew Vakulin, Carol Lang, Anne Taylor, Nick Antic, Peter Catcheside, Doug McEvoy, Gary Wittert

    Research output: Contribution to journalMeeting Abstract

    Abstract

    Introduction: Clinic studies have suggested a link between OSA and chronic kidney disease (CKD), but the only population-based study was in older adults (mean age 73 y) and did not show an independent association. We determined the association of OSA, CKD and co-morbidities in a community-based population of middle-aged and older men. Methods: A random sample of men without a previous diagnosis of OSA (n = 837) from the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) Study (a population cohort) undertook at home 8-channel polysomnography (PSG). Extensive biomedical and questionnaire based assessment of risk factors, and comorbidities occurred. Renal function was classified using the Cockcroft-Gault equation to calculate glomerular filtration rate (GFR, ml/min/1.73 m2). CKD was defined as a GFR < 60 (stage 3). Results: CKD occurred in 3.5% (n = 28) while 21.6% (n = 173) showed a GFR 60–89 (stage 2), similar to National Health Survey figures. Mean age of the cohort was 58 yr (standard deviation = 11). CKD was not significantly associated with OSA (p = 0.59) and occurred in 3.1% (n = 12) of men without OSA [apnoea hypopnea index (AHI) <10] compared with 3.8% (n = 16) in men with OSA (AHI ≥ 10). OSA was present in 57.1% (n = 16) of those with CKD compared to 52.0% (n = 402) of those without CKD. No significant relationship was seen for measures of nocturnal hypoxemia including oxygen desaturation index (ODI) > 16/hr or total sleep with oxygen desaturation <90% (TST90) <4% (75th percentile). When CKD stages were considered, GFR 60–89 was significantly more common in men with OSA [26.6% (n = 111)] than those with no OSA [16.2% (62)]. In multinomial regression analysis adjusted for age and hypertension, OSA was associated with GFR 60–89 [odds ratio (OR), 95% confidence interval (CI)]: 1.6 (1.1–2.3), p = 0.02, but not GFR < 60: 1.1 (0.5–2.4). ODI > 16 and TST90 > 4% showed no significant associations with GFR 60–89. Conclusion: Impaired renal function (GFR 60–89) but not CKD, was associated with OSA, an unselected, community-dwelling sample of middle-aged and older men. The number of men with CKD is a study limitation.
    Original languageEnglish
    Article number062
    Pages (from-to)19
    Number of pages1
    JournalSleep and Biological Rhythms
    Volume13
    Issue numberS1
    DOIs
    Publication statusPublished - Oct 2015
    EventSleep Down Under 2015 Cycles - Melbourne, Australia
    Duration: 22 Oct 201524 Oct 2015
    Conference number: 27th

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