Abstract
Abstract Background and Aims Sleep-disordered breathing (SDB) is known as a novel risk factor for cardiovascular disease, and one of five adults suffer from SDB in general population. In non-dialysis chronic kidney disease (CKD) and hemodialysis (HD) patients, a high prevalence of SDB has been reported due to the excess accumulation of extracellular fluid. However, precise prevalence and associated factors of SDB in patients with peritoneal dialysis (PD) has not been known. This cross-sectional study aimed to investigate the prevalence and determinant factors associated with SDB in patients with CKD. Method This was a single-center retrospective cohort study recruited 334 patients with CKD stages 1-3a, 3b-5, HD, and PD enrolled from 2018 to 2020. All patients were hospitalized and received our CKD educational program, and did not have sleep complaints. The diagnosis and assessment of the severity of SDB were evaluated using PULSOX-Me300 and SAS2100 systems. The 3% oxygen desaturation index and SpO2 were measured during sleep. SDB was defined as 3% oxygen desaturation index (ODI)>15.0 and SpO2<92% in this study. Results Proportion of the patients with CKD1-3a, CKD3b-5, HD, and PD were 28%, 53%, 11%, and 8%, respectively. Thirty-one% of the patients were diagnosed with SBD in all CKD patients. In a generalized linear model, 3% ODI>15.0 and SpO2<92% were significantly correlated with apnea hypopnea index (p<0.05, r=0.87 and p<0.05, r=-0.45, respectively). Further, it became clear that the proportion of 3%ODI>15 and SpO2<92% was significantly higher in PD patients (50%) than in other CKD patients. Furthermore, 3% ODI was significantly correlated with BMI and HDL cholesterol levels in PD patients (p<0.05, r=0.67 and p<0.05, r=-0.54, respectively). Conclusion We reported for the first time that the prevalence of SDB was very high and that the severity of SDB was significantly associated with BMI in patients with PD. These findings suggest that the extracellular fluid overload and excess glucose exposure due to PD fluid might accelerate SDB in patients with PD. Further clinical studies are needed to determine whether PD-associated SDB might influence the development of cardiovascular disease in CKD patients.
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