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“Sleep apnea as a risk factor for clinical outcomes in patients with chronic kidney disease”
Ana C. Ricardo, MD, MPH, MS Associate Professor of Medicine
College of Medicine, Department of Medicine, Division of Nephrology
University of Illinois Chicago
Chronic kidney disease is a growing public health problem that affects over 37 million adults in the U.S., including over 800,000 with kidney failure requiring dialysis or kidney transplant. Despite the magnitude of this problem, our understanding of risk factors for CKD progression is incomplete. A few years ago, we conducted a study to examine whether sleep duration and quality were associated with worsening kidney function. Using a wrist-worn device for five to seven days, we measured habitual sleep in over 430 adults with CKD participating in the Chronic Renal Insufficiency Cohort Study.
We found that high sleep fragmentation (waking up multiple times at night) and shorter sleep duration were each associated with worsening kidney function over time. We also found that daytime sleepiness was associated with increased risk of death. These findings suggest that abnormal sleep might be a significant risk factor for CKD progression. One of the limitations of the study was the lack of an objective measure of sleep apnea, a common sleep disorder that may be associated with worse kidney function. Sleep apnea has been associated with high blood pressure, diabetes and obesity. Despite the high prevalence of sleep apnea in adults with CKD, its role in CKD progression has not been previously evaluated. Therefore, we decided to conduct a second study sponsored by the NIH/NIDDK, to evaluate sleep apnea as a novel risk factor for CKD progression and other outcomes in patients with CKD.
We are currently enrolling adults participating in the CRIC Study who do not have kidney failure and who are not receiving treatment for sleep apnea. Thus far, we have recruited over 500 individuals across seven U.S. clinical centers who have agreed to wear a home sleep apnea testing device for one night. Our plan is to follow participants over time to examine whether having sleep apnea is associated with worsening kidney function and cardiovascular events. Since sleep apnea is a treatable condition, future studies are needed to evaluate whether treatment of sleep apnea might help slow down the progression of CKD. In addition, interventions to improve sleep hygiene and avoid short sleep duration need to be evaluated in patients with CKD.
About Our Researcher
Ana C. Ricardo is a nephrologist at the University of Illinois Chicago. Her research is focused on health disparities and health behaviors in CKD. Dr. Ricardo has led clinical research studies evaluating racial and ethnic, as well as sex-related differences in CKD progression and cardiovascular outcomes in adults with kidney disease. In addition, Dr. Ricardo has studied the impact of health behaviors including physical activity, smoking, diet and sleep on outcomes in individuals with CKD.
Source UIC Today