الفهرس 
Sleep related breathing disordersOnly 14 pages are availabe for public view
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Abstract
Sleep-disordered breathing (SDB) is highly prevalent in patients with advanced chronic kidney diseases (CKD). The aim of this study was to describe and compare the prevalence, severity, and patterns of SDB and associated nocturnal hypoxia among patients with advanced CKD, hemodialysis (HD) patients, and control group. Forty patients were recruited from outpatient nephrology clinics and hemodialysis unit. Patients were stratified into two groups: conservative (n = 25), and HD (n = 15). 30 healthy individual enrolled as control group. All participants completed polysomnography (PSG). The prevalence of SDB in CKD was 33/40(82.5%). In conservative group, AHI 148.84±147/h, [80% obstructive, 15%central, and 5%mixed apnea]. Among these conservative groups with OSA patients, 56% had severe, 31% moderate, and 12.5% mild OSA. While in HD group, AHI 133.26±111/h, [84.6% obstructive, 7.7% central, and 7.7% mixed apnea]. Among these HD group with OSA, 63% had severe, 27% moderate, and 9% mild OSA. GFR was significantly correlated with AHI and ODI (r=-0.315, P<0.05, r=-0.506, p< 0.001) respectively. AHI correlated with urea concentration (r=-0.094, P< 0.05). Increased creatinine, and decreased eGFR were significant risk factors of sever OSA. Predictors that reduced renal function included, decrease TST, delayed latency to REM sleep, and increased AHI. In conclusion: 1) Sleep related breathing disorders (SDB) tend to be under-recognized by renal healthcare providers. 2) Severe OSA is highly prevalent among advanced CKD & HD. 3) Patients with CKD are commonly exposed to nocturnal hypoxia related to both unrecognized sleep apnea and other factors. 4) There were statistical significant differences between the studied groups regarding socio-demographic data (age). 5) Patients with conservative group were the youngest and the greatest proportion of current smokers (P<0.001), and CKD patient had significant differences ESS (P< 0.05), compared with control group. 6) The prevalence of HTN, DM, and cardiovascular diseases were highly significant P<0.001 in those with conservative group. 7) Increased serum creatinine, decreased ionized calcium and decrease eGFR were associated with sever OSA and urea became stronger predictor of increased AHI. Sleep-disordered breathing (SDB) is highly prevalent in patients with advanced chronic kidney diseases (CKD). The aim of this study was to describe and compare the prevalence, severity, and patterns of SDB and associated nocturnal hypoxia among patients with advanced CKD, hemodialysis (HD) patients, and control group. Forty patients were recruited from outpatient nephrology clinics and hemodialysis unit. Patients were stratified into two groups: conservative (n = 25), and HD (n = 15). 30 healthy individual enrolled as control group. All participants completed polysomnography (PSG). The prevalence of SDB in CKD was 33/40(82.5%). In conservative group, AHI 148.84±147/h, [80% obstructive, 15%central, and 5%mixed apnea]. Among these conservative groups with OSA patients, 56% had severe, 31% moderate, and 12.5% mild OSA. While in HD group, AHI 133.26±111/h, [84.6% obstructive, 7.7% central, and 7.7% mixed apnea]. Among these HD group with OSA, 63% had severe, 27% moderate, and 9% mild OSA. GFR was significantly correlated with AHI and ODI (r=-0.315, P<0.05, r=-0.506, p< 0.001) respectively. AHI correlated with urea concentration (r=-0.094, P< 0.05). Increased creatinine, and decreased eGFR were significant risk factors of sever OSA. Predictors that reduced renal function included, decrease TST, delayed latency to REM sleep, and increased AHI. In conclusion: 1) Sleep related breathing disorders (SDB) tend to be under-recognized by renal healthcare providers. 2) Severe OSA is highly prevalent among advanced CKD & HD. 3) Patients with CKD are commonly exposed to nocturnal hypoxia related to both unrecognized sleep apnea and other factors. 4) There were statistical significant differences between the studied groups regarding socio-demographic data (age). 5) Patients with conservative group were the youngest and the greatest proportion of current smokers (P<0.001), and CKD patient had significant differences ESS (P< 0.05), compared with control group. 6) The prevalence of HTN, DM, and cardiovascular diseases were highly significant P<0.001 in those with conservative group. 7) Increased serum creatinine, decreased ionized calcium and decrease eGFR were associated with sever OSA and urea became stronger predictor of increased AHI.