PO-05-134 BURDEN OF ARRHYTHMIAS IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND SLEEP APNEA

Abstract

The prevalence of sleep apnea in patients with chronic kidney disease (CKD) is much more than in the general population. There is evidence of a bidirectional relationship between sleep apnea and CKD. Cardiovascular manifestations leading to worse outcomes in both conditions are well known. We studied the burden of arrhythmias and its impact on patients with CKD and sleep apnea. To study the burden of arrhythmias and its impact on patients with CKD and sleep apnea National Inpatient sample 2018-2020 was queried for adult patients with CKD stage 3-5. These patients were stratified based on the prevalence of sleep apnea. Demographics and association with different arrhythmias were analysed in both groups. Multivariate regression analysis was performed to study the impact of arrhythmias on mortality and total hospital cost in patients with CKD stage 3-5 and sleep apnea. A total of 13216345 adults with CKD stage 3-5 were hospitalised from 2018-2020 with a mean age of 73 years. 14.92% (n=1971955) of these patients had underlying sleep apnea out of which 40.03% were females. In the cohort of CKD, patients with sleep apnea had a higher prevalence of obesity (48.13% vs 16.49%; P<0.0001), hypertension (93.24% vs 88.78%; P<0.0001), chronic heart failure (21.98% vs 15.87%; P<0.0001), alcohol abuse (1.20 vs 0.92; P<0.0001) and hypothyroidism (21.16% vs 19.66%; P<0.0001). Arrhythmias including atrioventricular blocks, atrial flutter, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation were also more prevalent in patients with sleep apnea (Table 1). The prevalence of all these arrhythmias in patients with sleep apnea was 42.87% compared to 34.77% in patients without sleep apnea in a subgroup of CKD (P<0.0001). Multivariate regression analysis revealed 1.58 times higher odds of developing arrhythmias due to sleep apnea in patients with CKD (OR-1.58; C.I: 1.57- 1.59; P<0.0001). In a subgroup of patients with CKD and sleep apnea, the adjusted odds of mortality due to arrhythmia was 1.74 and total hospital cost was $13023 higher than those without arrhythmias (Table 2). Sleep apnea is an independent predictor for developing arrhythmias in patients with CKD. Arrhythmias tend to portend a worse prognosis and levy a higher burden on healthcare in patients with CKD and sleep apnea. Further studies are needed to better manage these cardiac complications to improve outcomes in patients with CKD.