Background. Sleep-disordered breathing (SDB) is common in severe chronic kidney disease (CKD) and may contribute to morbidity and mortality in this population. However, the association between mild to moderate CKD and likelihood of SDB is uncertain. Methods. We studied 2696 men ≥65 years (mean 73.0 ± 5.5) enrolled in the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) study who had serum creatinine (SCr) measured 3.4 years prior to overnight polysomnography (PSG). CKD was expressed as quartiles of estimated glomerular filtration rate (eGFR) using the four-variable Modification of Diet in Renal Disease (MDRD) formula. SDB was assessed using the respiratory disturbance index (RDI) with ≥4% oxygen desaturation. Results. Mean SCr was 0.99 ± 0.20 mg/dl; 14.8% had eGFR <60 ml/min/1.73 m2. Median RDI was 7.4 events/hour (inter-quartile range 2.6-15.8). Lower eGFR was not associated with higher mean RDI in the unadjusted model (P for trend = 0.180). There was evidence of an interaction between eGFR and age for the prediction of RDI; an association between lower eGFR and higher RDI was evident only among men ≤72 (median) years. Among this age group, however, the association was not statistically significant after further adjustment for body mass index (BMI) (P for trend = 0.278). Conclusions. In this cohort of older community-dwelling men, reduced renal function was not associated with greater evidence of SDB, except among younger old men. However, this association was largely explained by higher BMI at lower eGFR. Further prospective study in younger populations is needed to clarify our findings.
Bibliographical noteFunding Information:
Acknowledgements. The Osteoporotic Fractures in Men (MrOS) study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Cancer Institute (NCI), the National Center for Research Resources (NCRR) and NIH Roadmap for Medical Research under the following grant numbers: U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01-AG027810 and UL1 RR024140. The National Heart, Lung and Blood Institute (NHLBI) provides funding for the MrOS Sleep ancillary study ‘Outcomes of Sleep Disorders in Older Men’ under the following grant numbers: R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838 and R01 HL070839. Dr Canales’ time and training supported by National Institutes of Health funding as well through the National Institute of Diabetes and Digestive and Kidney Diseases, training grant T32 DK007784. Preliminary data from this analysis were presented in abstract form at the 21st Annual Meeting of the Associated Professional Sleep Societies, LLC in Minneapolis, MN, USA, June 2007, under the title ‘Reduced Renal Function and Sleep Apnea in Community-Dwelling Elderly Men’. Finally, we would like to acknowledge Mr Kyle A. Moen for his assistance in preparation of the manuscript and formatting of the tables.
- Chronic kidney disease
- Kidney dysfunction
- Sleep disorders