Obstructive sleep apnea and hypertension in pediatric chronic kidney disease.
Adolescent
Blood Pressure
/ physiology
Blood Pressure Monitoring, Ambulatory
Child
Female
Humans
Hypertension
/ diagnosis
Male
Polysomnography
Prospective Studies
Renal Insufficiency, Chronic
/ complications
Sleep
/ physiology
Sleep Apnea, Obstructive
/ diagnosis
Surveys and Questionnaires
/ statistics & numerical data
Children
Chronic kidney disease
Hypertension
Polysomnography
Sleep-disordered breathing
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
05
02
2019
accepted:
12
06
2019
revised:
04
06
2019
pubmed:
30
6
2019
medline:
25
8
2020
entrez:
30
6
2019
Statut:
ppublish
Résumé
Children with chronic kidney disease (CKD) are at risk for obstructive sleep apnea (OSA) and hypertension. The objectives of this study were to explore associations between OSA severity using the apnea-hypopnea-index(AHI) and obstructive apnea-hypopnea-index(OAHI) on polysomnography (PSG), OSA symptoms, and measures of hypertension in children with CKD. One-night in-laboratory PSGs and 24-h ambulatory blood pressure monitoring (ABPM) were performed on children with CKD stages 2-5 (non-dialysis dependent). Sleep questionnaires, including the modified Epworth Sleepiness Scale (ESS) and the Pediatric Sleep Questionnaire (PSQ), were administered during the sleep study. Nineteen children and adolescents completed a PSG and questionnaires and thirteen completed ABPMs. Mean (standard deviation) age at the time of the sleep study was 14.1 (3.2) years. Eleven (58%) participants had CKD stage two, and eight (42%) had stage 3-4. None of the participants were found to have OSA on PSG. One participant had a positive ESS score (≥ 11) and five participants had positive PSQ scores (≥ eight). Night systolic and diastolic pressures were strongly correlated with the OAHI (r = 0.67 and r = 0.69, respectively, p < 0.05), while the AHI was not correlated with any blood pressure measures. Our study did not find OSA on PSG in children with predominantly mild to moderate CKD. The OAHI was found to be strongly correlated with nighttime blood pressures. Future prospective studies with a larger sample size are needed to monitor for potential progression of symptoms and findings on PSG in pediatric patients as they evolve across the spectrum of CKD.
Sections du résumé
BACKGROUND
Children with chronic kidney disease (CKD) are at risk for obstructive sleep apnea (OSA) and hypertension. The objectives of this study were to explore associations between OSA severity using the apnea-hypopnea-index(AHI) and obstructive apnea-hypopnea-index(OAHI) on polysomnography (PSG), OSA symptoms, and measures of hypertension in children with CKD.
METHODS
One-night in-laboratory PSGs and 24-h ambulatory blood pressure monitoring (ABPM) were performed on children with CKD stages 2-5 (non-dialysis dependent). Sleep questionnaires, including the modified Epworth Sleepiness Scale (ESS) and the Pediatric Sleep Questionnaire (PSQ), were administered during the sleep study.
RESULTS
Nineteen children and adolescents completed a PSG and questionnaires and thirteen completed ABPMs. Mean (standard deviation) age at the time of the sleep study was 14.1 (3.2) years. Eleven (58%) participants had CKD stage two, and eight (42%) had stage 3-4. None of the participants were found to have OSA on PSG. One participant had a positive ESS score (≥ 11) and five participants had positive PSQ scores (≥ eight). Night systolic and diastolic pressures were strongly correlated with the OAHI (r = 0.67 and r = 0.69, respectively, p < 0.05), while the AHI was not correlated with any blood pressure measures.
CONCLUSIONS
Our study did not find OSA on PSG in children with predominantly mild to moderate CKD. The OAHI was found to be strongly correlated with nighttime blood pressures. Future prospective studies with a larger sample size are needed to monitor for potential progression of symptoms and findings on PSG in pediatric patients as they evolve across the spectrum of CKD.
Identifiants
pubmed: 31254112
doi: 10.1007/s00467-019-04295-7
pii: 10.1007/s00467-019-04295-7
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2361-2370Références
Sleep. 2011 Nov 01;34(11):1509-17
pubmed: 22043122
Pediatr Pulmonol. 1988;4(3):139-43
pubmed: 2836784
Pediatrics. 2011 Jul;128(1):e85-92
pubmed: 21708802
Pediatrics. 2014 Jan;133(1):e64-72
pubmed: 24344109
Chest. 2012 Jun;141(6):1422-1430
pubmed: 22222188
Sleep Med. 2000 Feb 1;1(1):21-32
pubmed: 10733617
J Am Soc Nephrol. 2012 Apr;23(4):578-85
pubmed: 22383696
Arch Pediatr Adolesc Med. 2009 Sep;163(9):850-5
pubmed: 19736340
Hypertension. 2008 Sep;52(3):433-51
pubmed: 18678786
Saudi J Kidney Dis Transpl. 2013 Jul;24(4):714-8
pubmed: 23816719
Int J Pediatr Otorhinolaryngol. 2012 Jun;76(6):787-90
pubmed: 22429512
World J Cardiol. 2010 Aug 26;2(8):251-6
pubmed: 21160592
J Pediatr. 2012 Jul;161(1):26-30
pubmed: 22284918
J Clin Sleep Med. 2013 Jan 15;9(1):31-8
pubmed: 23319902
Pediatr Nephrol. 2015 Dec;30(12):2135-43
pubmed: 26156709
Adv Chronic Kidney Dis. 2005 Oct;12(4):378-84
pubmed: 16198277
Pediatr Pulmonol. 2013 Mar;48(3):274-9
pubmed: 22615200
Nephrol Dial Transplant. 2012 Apr;27(4):1569-73
pubmed: 22058175
Hypertension. 2008 Jan;51(1):84-91
pubmed: 18071053
Paediatr Child Health. 2014 Aug;19(7):367-72
pubmed: 25332676
J Cardiovasc Transl Res. 2011 Feb;4(1):53-60
pubmed: 21104045
J Pediatr. 2003 Apr;142(4):377-82
pubmed: 12712054
Circulation. 2008 Sep 2;118(10):1034-40
pubmed: 18711015
Pediatr Nephrol. 2005 Jan;20(1):69-75
pubmed: 15565279
Am J Kidney Dis. 2010 Feb;55(2):269-80
pubmed: 20034719
Am J Respir Crit Care Med. 2004 Apr 15;169(8):950-6
pubmed: 14764433
J Hypertens. 2016 Oct;34(10):1887-920
pubmed: 27467768
J Clin Sleep Med. 2015 Aug 15;11(8):915-24
pubmed: 25845900
Hypertension. 2008 Oct;52(4):631-7
pubmed: 18725579
J Am Soc Nephrol. 2001 Dec;12(12):2854-9
pubmed: 11729258
Pediatr Nephrol. 2009 Mar;24(3):545-8
pubmed: 19048298
Nephrol Dial Transplant. 2007 Apr;22(4):1190-7
pubmed: 17277346
Pediatr Nephrol. 2012 Mar;27(3):451-9
pubmed: 21964556
Hong Kong Med J. 2003 Oct;9(5):353-6
pubmed: 14530530
Pediatrics. 2004 Sep;114(3):768-75
pubmed: 15342852
J Am Soc Nephrol. 2009 Mar;20(3):629-37
pubmed: 19158356
Pediatrics. 2012 Sep;130(3):e714-55
pubmed: 22926176
Am J Kidney Dis. 2002 Feb;39(2 Suppl 1):S1-266
pubmed: 11904577
Pediatr Nephrol. 2013 May;28(5):773-95
pubmed: 23334386
J Clin Sleep Med. 2017 Oct 15;13(10):1199-1203
pubmed: 28877820
Pediatr Nephrol. 2016 Aug;31(8):1221-9
pubmed: 26482250
Nutr Metab Cardiovasc Dis. 2007 Mar;17(3):233-40
pubmed: 17314035
Sleep Med. 2018 May;45:140-145
pubmed: 29680422
Hypertension. 2012 Jul;60(1):43-50
pubmed: 22585950
Sleep Med Rev. 2013 Feb;17(1):75-85
pubmed: 22647560