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Volume 13 No. 10
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Scientific Investigations

Independent Contributions of Obstructive Sleep Apnea and the Metabolic Syndrome to the Risk of Chronic Kidney Disease

Yu-Ji Lee, MD, PhD1; Hye Ryoun Jang, MD, PhD2; Wooseong Huh, MD, PhD2; Yoon-Goo Kim, MD, PhD2; Dae Joong Kim, MD, PhD2; Ha Young Oh, MD, PhD2; Eun Yeon Joo, MD, PhD3,4; Jung Eun Lee, MD, PhD2
1Division of Nephrology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; 2Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 3Department of Neurology, Neuroscience Center, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 4Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea

Study Objectives:

This retrospective study was conducted to evaluate the associations and interactions among obstructive sleep apnea (OSA), chronic kidney disease (CKD), and metabolic syndrome (MS).

Methods:

This study included 1,732 subjects (1,482 male and 250 female) in whom OSA was diagnosed by polysomnography. The severity of OSA was defined as mild, moderate, or severe with an apnea-hypopnea index (AHI) score of 5 to < 15, 15 to < 30, and ≥ 30 events/h, respectively. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 or albuminuria.

Results:

The prevalence of MS was 29.2% (n = 505). One hundred twenty-nine subjects (7.4%) had CKD. In subjects with MS, CKD prevalence increased progressively with OSA severity: 7.4%, 12.5%, and 15.8% in those with mild, moderate, or severe OSA, respectively (P = .025). Each 10-point increment in AHI score was independently associated with a 1.15-fold higher prevalence of CKD [95% confidence interval (CI), 1.036–1.280; P = .009] after adjustment for all individual components of MS. On the contrary, in those without MS, AHI was not associated with increased odds for CKD [odds ratio, 1.054; 95% CI, 0.930–1.195].

Conclusions:

The independent association between OSA severity and CKD prevalence was observed only in subjects with MS. Further studies are needed to ascertain if OSA contributes to the development of CKD in subjects with MS.

Citation:

Lee YJ, Jang HR, Huh W, Kim YG, Kim DJ, Oh HY, Joo EY, Lee JE. Independent contributions of obstructive sleep apnea and the metabolic syndrome to the risk of chronic kidney disease. J Clin Sleep Med. 2017;13(10):1145–1152.




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