High risk of obstructive sleep apnea is a risk factor of death censored graft loss in kidney transplant recipients

An observational cohort study

Andras Szentkiralyi, Maria E. Czira, Miklos Z. Molnar, Csaba Kovesdy, Adam Remport, Lilla Szeifert, Eszter P. Vamos, Janos Juhasz, Csilla Z. Turanyi, Istvan Mucsi, Marta Novak

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives: Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular morbidity in the general population. The clinical significance of OSA among kidney transplant patients is unknown. Our aim was to investigate the association of " high risk of OSA" with death-censored graft loss and mortality in a large cohort of kidney transplant recipients. Patients and methods: Using the Berlin questionnaire 1067 prevalent kidney transplant recipients were assessed for risk of OSA. Socio-demographic variables, laboratory parameters and data about graft loss and mortality were obtained from the medical records. Multivariable-adjusted associations of OSA risk with graft loss and with all-cause mortality was assessed in competing-risks regression models. Results: Of the 823 patients who completed the Berlin questionnaire 28% had high risk of OSA (HRO) at baseline. Patients with HRO were older (52±11 vs. 47±13years, p<0.001), had a higher prevalence of diabetes (22 vs. 15%, p=0.018), worse baseline kidney function (estimated glomerular filtration rate: 46±18 vs. 51±19ml/min/1.73m2, p=0.001) and higher BMI (27±5 vs. 24±4kg/m2, p<0.001). In multivariate models HRO was an independent predictor of graft loss among females after adjusting for age, comorbidity, hypertension, BMI, kidney function, duration of chronic kidney disease, other laboratory parameters and transplant-related data (HR=3.05; CI: 1.24-7.51; p=0.015), while HRO did not predict graft survival among males. HRO at baseline was not independently associated with all-cause mortality in the sample. Conclusion: High risk of OSA is an independent predictor of graft loss among female kidney transplant patients.

Original languageEnglish (US)
Pages (from-to)267-273
Number of pages7
JournalSleep Medicine
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

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Obstructive Sleep Apnea
Observational Studies
Cohort Studies
Transplants
Kidney
Mortality
Berlin
Transplant Recipients
Graft Survival
Glomerular Filtration Rate
Chronic Renal Insufficiency
Medical Records
Comorbidity
Demography
Hypertension
Morbidity

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

High risk of obstructive sleep apnea is a risk factor of death censored graft loss in kidney transplant recipients : An observational cohort study. / Szentkiralyi, Andras; Czira, Maria E.; Molnar, Miklos Z.; Kovesdy, Csaba; Remport, Adam; Szeifert, Lilla; Vamos, Eszter P.; Juhasz, Janos; Turanyi, Csilla Z.; Mucsi, Istvan; Novak, Marta.

In: Sleep Medicine, Vol. 12, No. 3, 01.03.2011, p. 267-273.

Research output: Contribution to journalArticle

Szentkiralyi, A, Czira, ME, Molnar, MZ, Kovesdy, C, Remport, A, Szeifert, L, Vamos, EP, Juhasz, J, Turanyi, CZ, Mucsi, I & Novak, M 2011, 'High risk of obstructive sleep apnea is a risk factor of death censored graft loss in kidney transplant recipients: An observational cohort study', Sleep Medicine, vol. 12, no. 3, pp. 267-273. https://doi.org/10.1016/j.sleep.2010.08.012
Szentkiralyi, Andras ; Czira, Maria E. ; Molnar, Miklos Z. ; Kovesdy, Csaba ; Remport, Adam ; Szeifert, Lilla ; Vamos, Eszter P. ; Juhasz, Janos ; Turanyi, Csilla Z. ; Mucsi, Istvan ; Novak, Marta. / High risk of obstructive sleep apnea is a risk factor of death censored graft loss in kidney transplant recipients : An observational cohort study. In: Sleep Medicine. 2011 ; Vol. 12, No. 3. pp. 267-273.
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T1 - High risk of obstructive sleep apnea is a risk factor of death censored graft loss in kidney transplant recipients

T2 - An observational cohort study

AU - Szentkiralyi, Andras

AU - Czira, Maria E.

AU - Molnar, Miklos Z.

AU - Kovesdy, Csaba

AU - Remport, Adam

AU - Szeifert, Lilla

AU - Vamos, Eszter P.

AU - Juhasz, Janos

AU - Turanyi, Csilla Z.

AU - Mucsi, Istvan

AU - Novak, Marta

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Objectives: Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular morbidity in the general population. The clinical significance of OSA among kidney transplant patients is unknown. Our aim was to investigate the association of " high risk of OSA" with death-censored graft loss and mortality in a large cohort of kidney transplant recipients. Patients and methods: Using the Berlin questionnaire 1067 prevalent kidney transplant recipients were assessed for risk of OSA. Socio-demographic variables, laboratory parameters and data about graft loss and mortality were obtained from the medical records. Multivariable-adjusted associations of OSA risk with graft loss and with all-cause mortality was assessed in competing-risks regression models. Results: Of the 823 patients who completed the Berlin questionnaire 28% had high risk of OSA (HRO) at baseline. Patients with HRO were older (52±11 vs. 47±13years, p<0.001), had a higher prevalence of diabetes (22 vs. 15%, p=0.018), worse baseline kidney function (estimated glomerular filtration rate: 46±18 vs. 51±19ml/min/1.73m2, p=0.001) and higher BMI (27±5 vs. 24±4kg/m2, p<0.001). In multivariate models HRO was an independent predictor of graft loss among females after adjusting for age, comorbidity, hypertension, BMI, kidney function, duration of chronic kidney disease, other laboratory parameters and transplant-related data (HR=3.05; CI: 1.24-7.51; p=0.015), while HRO did not predict graft survival among males. HRO at baseline was not independently associated with all-cause mortality in the sample. Conclusion: High risk of OSA is an independent predictor of graft loss among female kidney transplant patients.

AB - Objectives: Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular morbidity in the general population. The clinical significance of OSA among kidney transplant patients is unknown. Our aim was to investigate the association of " high risk of OSA" with death-censored graft loss and mortality in a large cohort of kidney transplant recipients. Patients and methods: Using the Berlin questionnaire 1067 prevalent kidney transplant recipients were assessed for risk of OSA. Socio-demographic variables, laboratory parameters and data about graft loss and mortality were obtained from the medical records. Multivariable-adjusted associations of OSA risk with graft loss and with all-cause mortality was assessed in competing-risks regression models. Results: Of the 823 patients who completed the Berlin questionnaire 28% had high risk of OSA (HRO) at baseline. Patients with HRO were older (52±11 vs. 47±13years, p<0.001), had a higher prevalence of diabetes (22 vs. 15%, p=0.018), worse baseline kidney function (estimated glomerular filtration rate: 46±18 vs. 51±19ml/min/1.73m2, p=0.001) and higher BMI (27±5 vs. 24±4kg/m2, p<0.001). In multivariate models HRO was an independent predictor of graft loss among females after adjusting for age, comorbidity, hypertension, BMI, kidney function, duration of chronic kidney disease, other laboratory parameters and transplant-related data (HR=3.05; CI: 1.24-7.51; p=0.015), while HRO did not predict graft survival among males. HRO at baseline was not independently associated with all-cause mortality in the sample. Conclusion: High risk of OSA is an independent predictor of graft loss among female kidney transplant patients.

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