Source: Annual Congress 2009 - Socio-economic and epidemiological aspects of sleep apnoea
Disease area: Sleep and breathing disorders

Abstract

A relationship between obstructive sleep apnea syndrome (OSAS) and chronic renal failure (CRF) has been suggested. In dialyzed CRF patients a high prevalence of OSAS has been demonstrated, probably due to interstitial edema that reduces pharyngeal lumen, pulmonary edema with lung volume reduction, and muscular atrophy due to uremia. This study aimed to evaluate 1) the prevalence of OSAS in a population of non-dialyzed CRF patients (glomerular filtration rate, GFR, <60 ml/min/1,72 m²) aged <80 years, and 2) the correlation between the severity of OSAS and patients‘ characteristics (anthropometric data, ventilatory, and renal function). We screened 99 consecutive outpatients (aged 69±16 yrs, 31 females); 29 were excluded for age >80 yrs or GFR> 60 ml/min/1,72 m². 70 patients (aged 66±13 yrs, 21 females) filled in the Berlin Questionnaire and Epworth Sleepiness Scale. In 37 patients almost one of the two questionnaires had a score significant for sleep disorder; 14 patients dropped-out (unwilling to carry out nocturnal cardio-respiratory monitoring, NCM) whilst 23 underwent spirometry and NCM. 20 patients (6 females) out of the 23 whom we studied had the diagnosis of OSAS (mean apnea-hypopnea index, AHI: 29±22, mean oxygen desaturation index: 29±21), with a prevalence among enrolled patients of 29%. The severity of OSAS was not correlated with the severity of renal failure, whilst we found a significant correlation between AHI and BMI (p= 0.012), and AHI and forced vital capacity (p=0.001). The presence of OSAS should be investigated in non-dialyzed CRF patients, since its prevalence resulted at least 4-5 fold higher in this group in comparison with general population.

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F. Di Marco, S. M. Pizzolato, M. Cozzolino, E. Zambrelli, G. F. Sferrazza Papa, D. Brancaccio, S. Centanni (Milan, Italy). High prevalence of obstructive sleep apnea syndrome in nondialyzed severe chronic renal failure patients. Eur Respir J 2009; 34: Suppl. 53, 3676

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