Assessment of the Prevalence of Sleep Apnea in Patients with Chronic Kidney Disease
DOI:
https://doi.org/10.5281/zenodo.24173240Keywords:
Sleep Apnea, Obstructive, Renal Insufficiency, Chronic, Polysomnography, Glomerular Filtration RateAbstract
Introduction: Sleep apnea is a common but underdiagnosed comorbidity in patients with chronic kidney disease (CKD), and its severity with declining renal function.
Objective: To determine the prevalence of sleep apnea in patients with CKD using the Apnea-Hypopnea Index (AHI) on polysomnography, and to examine its association with CKD stage and estimated glomerular filtration rate (eGFR).
Methods: An observational, cross-sectional study was conducted over six months in the renal department of a tertiary care hospital and enrolled 100 patients with CKD (stages 1–5, age ≥18 years, both sexes). Sleep apnea risk was screened using the stop-bang questionnaire; patients classified as moderate or high risk underwent polysomnography for AHI-based diagnosis and severity grading. Associations between CKD stage and AHI were analysed with one-way ANOVA, and the eGFR–AHI relationship was assessed using Pearson correlation.
Results: Of 100 patients, STOP-BANG classified 60% as high risk and 11% as moderate risk. Among the 71 patients who underwent polysomnography, AHI-confirmed sleep apnea was severe in 42%, moderate in 19%, and mild in 10%. Mean AHI rose progressively with CKD stage, from 20.67 in stage 2 to 48.90 in stage 5 (one-way ANOVA, p < 0.0000). eGFR correlated strongly and negatively with AHI (r = −0.7891, p < 0.001). Only male gender was significantly associated with sleep apnea among candidate risk factors (p = 0.026).
Conclusion: Sleep apnea is highly prevalent among patients with CKD and becomes progressively more severe as renal function declines. STOP-BANG-based screening followed by confirmatory polysomnography identifies a substantial burden of unrecognised sleep apnea and supports routine screening, particularly in advanced CKD.
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