Sleep-disordered breathing in patients with polycystic liver and kidney disease referred for transcatheter arterial embolization

Abstract

Background and objectives: Sleep-disordered breathing (SDB) is prevalent among patients with CKD, but its prevalence among patients with symptomatic autosomal dominant polycystic kidney disease (ADPKD) and its association with total liver and kidney volume remain unclear. Design, setting, participants, &measurements: This study examined the association between height-adjusted total liver and kidney volume (htTLKV) and SDB in a cross-sectional study of 304 adult patients with symptomatic ADPKD who were hospitalized at Toranomon Hospital for transcatheter arterial embolization and who underwent pulse oximetry between April 2008 and November 2013. SDB was defined as having a 3% oxygen desaturation index of ≥15 events per hour of sleep. Logistic regression was performed with sex-specific quartiles of htTLKV as the main predictor, using patient data and comorbidities as covariates. Results: Overall (54.6% women, mean age 56.2±9.4 years, 83.5% on hemodialysis), 177 of 304 patients (58.2%) had SDB. SDB was strongly associated with htTLKV quartiles, demonstrating that odds ratios (ORs) and 95% confidence intervals (95% CIs) for SDB were 1.63 (0.76 to 3.48), 2.35 (1.09 to 5.06), and 4.61 (1.98 to 10.7) for htTLKV quartiles 2–4 (P for trend, P=0.003), respectively. Older age (OR, 1.81 per 10 years; 95% CI, 1.29 to 2.55), male sex (OR, 3.87; 95% CI, 1.96 to 7.66), receiving hemodialysis (OR, 3.46; 95% CI, 1.62 to 12.1), and higher body mass index (≥25 kg/m2) (OR, 3.03; 95% CI, 1.08 to 8.52) were also associated with SDB. Conclusions: In this highly selected population of patients with symptomatic ADPKD referred for transcatheter arterial embolization, SDB was highly prevalent and independently associated with higher htTLKV.