Association between Plaque Score of the Carotid Artery and the Severity of Sleep Apnea Syndrome in Patients with Chronic Kidney Disease

Abstract

Background: Recently, sleep apnea syndrome (SAS) has been associated with hypertension, cardiovascular disease and death. Patients with chronic kidney disease (CKD) have higher rates of SAS, atherosclerotic complications and death than do patients without CKD. Although the relationship between SAS and atherosclerosis is well known, few papers have described this relationship in humans, especially in CKD patients. Patients and Methods: This was a cross-sectional study of 110 clinically stable, non-dialysis patients with CKD who attended a CKD educational program from April 2014 to September 2015. The diagnosis of SAS and its severity were assessed using a type 3 portable monitor. Other atherosclerosis-related data were obtained from the patients' medical records in order to determine the factors associated with the severity of SAS. Results: 95 men and 15 women with a mean age of 71.4 ± 9.9 years were included in the study. The patients' mean body mass index was 24.0 ± 3.9, their mean blood pressure 134.3 ± 21.2/73.6 ± 13.4 mm Hg and their mean estimated glomerular filtration rate 19.8 ± 9.5 ml/min/1.7 m2. Adjusted plaque score was a significant predictor of severe SAS (odds ratio = 1.13, p = 0.0182). Mixed plaque was significantly associated with severe SAS (correlation ratio = 0.48, p < 0.0001). Conclusions: Many patients with CKD also have SAS. Our findings demonstrate the relationship between plaque score and the severity of SAS.