Impact of kidney transplantation on sleep apnea severity: A prospective polysomnographic study. Issue 6 (21st January 2020)

• Record Type: Journal Article
• Authors: Forni Ogna, Valentina; Ogna, Adam; Haba‐Rubio, José; Nowak, Grzegorz; Venetz, Jean‐Pierre; Golshayan, Délaviz; Matter, Maurice; Burnier, Michel; Pascual, Manuel; Heinzer, Raphaël
• Is Part Of: American journal of transplantation. Volume 20:Issue 6(2020)
• Page Start: 1659
• Page End: 1667
• Publication Date: 2020-01-21
• Subjects: clinical research/practice -- disease pathogenesis -- kidney transplantation/nephrology -- kidney transplantation: living donor -- lung disease; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.15771
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Fluid overload has been associated with a high prevalence of sleep apnea (SA) in patients with end‐stage kidney disease (ESKD). In this prospective study, we hypothesized that improvement in kidney function and hydration status after kidney transplantation (Tx) may result in an improvement in SA severity. A total of 196 patients on the kidney Tx waiting list were screened for SA using home nocturnal polysomnography (PSG) to measure the apnea‐hypopnea index (AHI) and underwent bioimpedance to assess body composition. Of 88 participants (44.9%) with SA (AHI ≥ 15/h), 42 were reassessed 6 months post‐Tx and were compared with 27 control patients. There was a significant, but small, post‐Tx improvement in AHI (from 44.2 ± 24.3 to 34.7 ± 20.9/h, P = .02) that significantly correlated with a reduction in fluid overload (from 1.8 ± 2.0 to 1.2 ± 1.2 L, P = .02) and body water (from 54.9% to 51.6%, P = .003). A post‐Tx increase in body fat mass (from 26% to 30%, P = .003) possibly blunted the beneficial impact of kidney Tx on SA. All parameters remained unchanged in the control group. In conclusion, SA is a frequent condition in ESKD patients and partially improved by kidney Tx. We suggest that SA should be systematically assessed before and after kidney Tx. ClinicalTrials.gov Identifier: NCT02020642. Abstract : This prospective study shows that improvement of kidney function and hydration status after kidney transplantation results in a significant improvement of sleep apnea severity.