关键词: 肾病, 睡眠呼吸暂停综合征, 肾小球滤过率

Abstract: Objective　To evaluate the prevalence and associated factors of sleep-disordered breathing （SDB） in patients with different stages of chronic kidney disease （CKD）.Methods　A total of 132 inpatients from Department of Nephrology，Beijing Tiantan Hospital were enrolled during August 2016 to May 2017.We collected their baseline characteristics，laboratory test data，available parameters associated with sleep quality such as apnea-hypopnea index （AHI） and oxygen desaturation index （ODI） derived from the automatic analysis of overnight sleep monitoring results （performed in the department） by Morpheus Ox web-based server software.Based on the definition of CKD and the eGFR level calculated by the modified CKD-EPI equation for Chinese populations with CKD，the patients were divided into non-CKD group，CKD 1-3 stages group，CKD 4-5 stages with dialysis group.Sleep quality was assessed by the Epworth Sleepiness Scale （ESS）and the Pittsburgh Sleep Quality Index （PSQI） .Statistical significance of the differences between three groups was tested using one-way ANOVA for continuous variables and χ2 test for categorical variables.Multivariable Logistic regression analysis was used to investigate the associated factors of moderate to severe SDB.Results　The distribution of age and systolic blood pressure （SBP），percentages of hypertension history，and cardiovascular disease history differed significantly between the three groups （P<0.05），while the distribution of sex，diastolic blood pressure （DBP） and body mass index （BMI），prevalence of smoking and alcohol consumption，percentage of diabetes history did not （P>0.05）.The distribution of eGFR，hemoglobin and albumin levels varied obviously between the three groups （P<0.05），but that of total cholesterol and fasting blood glucose levels did not（P>0.05）.Three groups demonstrated similar mean AHI，similar percent of patients with an AHI≥15 and similar mean ESS score （P>005），but significantly different mean ODI and PSQI （P<0.05）.The percent of patients with an ODI≥5 in CKD 4-5 stages with dialysis group was higher than that of non-CKD group （P<0.017）.The mean PSQI score was significantly higher in CKD 4-5 stages with dialysis group compared with that of other two groups （P<0.017）.Univariate Logistic stepwise regression analysis showed that age，hypertension，BMI and eGFR levelwere associated with mild to severe SDB （P<0.05），and in multivariate regression analysis， BMI and eGFR level were independently associated with mild to severe SDB （P<0.05）.Conclusion　Different mean ODI and PSQI in patients with different stages of CKD； decreased eGFR level as well as increased BMI were the risk factors for mild to severe SDB.

Key words: Nephrosis, Sleep apnea syndromes, Glomerular filtration rate