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© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

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This retrospective evaluation of the association of sleep disorder diagnosis and mortality in end-stage renal disease (ESRD) patients emphasizes the importance of the diagnosis and treatment of sleep disorders in this population.

Abstract

Increased risk of all-cause mortality not accounted for by traditional cardiovascular risk factors has been linked to chronic kidney disease. This study tested the hypothesis that mortality may be greater in patients with end-stage renal disease (ESRD) and a sleep disorder diagnosis. The United States Renal Data System database was queried to determine the effect of sleep disorder diagnoses on mortality in ESRD patients enrolled between 2004 and 2015. Sleep disorders were identified using International Classification of Diseases-9 and -10 codes. Mortality risk associated with sleep disorders was examined using Cox proportional hazards (CPH) modeling. In the final CPH model, sleep disorder diagnoses were associated with decreased risk of mortality, with hazard ratios (and 95% confidence intervals) for insomnia, hypersomnolence, restless leg syndrome, and obstructive/central sleep apnea of 0.76 (0.75–0.76), 0.81 (0.78–0.84), 0.79 (0.77–0.80), and 0.82 (0.81–0.82), respectively. Black or other race and Hispanic ethnicity, and to a small extent, female sex and increasing Charlson comorbidity index, were also associated with decreased risk, whereas increasing age, hemodialysis (versus peritoneal dialysis) and catheter or graft access type were associated with increased risk. This study suggests that the diagnosis of a sleep disorder may be associated with improved survival in ESRD patients.

Details

Title
The Effect of Sleep Disorder Diagnosis on Mortality in End-Stage Renal Disease Patients
Author
Mixson, Andrew 1 ; Waller, Jennifer L 2 ; Bollag, Wendy B 3   VIAFID ORCID Logo  ; Taskar, Varsha 4 ; Baer, Stephanie L 5 ; Padala, Sandeep 4   VIAFID ORCID Logo  ; Healy, William J 4   VIAFID ORCID Logo 

 School of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA 
 Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA 
 Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; Charlie Norwood VA Medical Center, Augusta, GA 30904, USA 
 Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA 
 Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; Charlie Norwood VA Medical Center, Augusta, GA 30904, USA 
First page
5354
Publication year
2023
Publication date
2023
Publisher
MDPI AG
e-ISSN
20763417
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2812407382
Copyright
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.