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Association of sleep apnea with mortality in patients with advanced kidney disease

Clinical Journal of the American Society of Nephrology Feb 13, 2020

Jhamb M, Ran X, Abdalla H, et al. - Researchers undertook this prospective cohort analysis among patients with CKD and ESKD, to determine the link between sleep apnea and mortality in these individuals. In-home polysomnography was performed on 180 patients (88 with CKD stage 4 or 5, 92 with ESKD), and for these patients, sleep apnea measures such as apnea hypopnea index (AHI) and nocturnal hypoxemia were collected. Using the National Death Index, they gathered mortality data. Survival analysis was performed using Cox proportional hazard models. A median follow-up of 9 years was conducted. No significant link of AHI with death was revealed following adjustment for age, gender, race, diabetes, body mass index, CKD/ESKD status, and kidney transplant status. A significant link with higher mortality was shown by a higher proportion of sleep time with oxygen saturation <90% as well as by a lower mean oxygen saturation, in the adjusted analysis. No connection of sleep duration, sleep efficiency, or periodic limb movement index, with mortality, was revealed. Overall, findings revealed a significant link between hypoxemia-based measures of sleep apnea and increased risk of mortality among patients with advanced CKD and ESKD.
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