Fluid overload has been associated with a high prevalence of sleep apnea (SA) in patients with end-stage kidney disease (ESKD). In this prospective study, we hypothesized that improvement in kidney function and hydration status after kidney transplantation (Tx) may result in an improvement in SA severity. A total of 196 patients on the kidney Tx waiting list were screened for SA using home nocturnal polysomnography (PSG) to measure the apnea-hypopnea index (AHI) and underwent bioimpedance to assess body composition. Of 88 participants (44.9%) with SA (AHI ≥ 15/h), 42 were reassessed 6 months post-Tx and were compared with 27 control patients. There was a significant, but small, post-Tx improvement in AHI (from 44.2 ± 24.3 to 34.7 ± 20.9/h, P = .02) that significantly correlated with a reduction in fluid overload (from 1.8 ± 2.0 to 1.2 ± 1.2 L, P = .02) and body water (from 54.9% to 51.6%, P = .003). A post-Tx increase in body fat mass (from 26% to 30%, P = .003) possibly blunted the beneficial impact of kidney Tx on SA. All parameters remained unchanged in the control group. In conclusion, SA is a frequent condition in ESKD patients and partially improved by kidney Tx. We suggest that SA should be systematically assessed before and after kidney Tx. ClinicalTrials.gov Identifier: NCT02020642.

中文翻译：

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肾移植对睡眠呼吸暂停严重程度的影响：一项前瞻性多导睡眠图研究。

液体超负荷与终末期肾病 (ESKD) 患者睡眠呼吸暂停 (SA) 的高患病率有关。在这项前瞻性研究中，我们假设肾移植 (Tx) 后肾功能和水化状态的改善可能导致 SA 严重程度的改善。使用家庭夜间多导睡眠图 (PSG) 测量呼吸暂停低通气指数 (AHI) 并接受生物阻抗评估身体成分，共有 196 名肾脏 Tx 等待名单上的患者接受了 SA 筛查。在 88 名患有 SA（AHI ≥ 15/h）的参与者（44.9%）中，42 名在 Tx 后 6 个月进行了重新评估，并与 27 名对照患者进行了比较。Tx 后 AHI 有显着但小的改善（从 44.2 ± 24.3 到 34.7 ± 20.9/h，P = .02），这与液体过载的减少显着相关（从 1.8 ± 2.0 到 1.2 ± 1.2 L , P = .02) 和身体水分（从 54.9% 到 51.6%，P = .003）。Tx 后体脂量增加（从 26% 到 30%，P = .003）可能削弱了肾脏 Tx 对 SA 的有益影响。对照组所有参数保持不变。总之，SA 是 ESKD 患者的常见病症，并且通过肾脏 Tx 得到部分改善。我们建议在肾脏 Tx 之前和之后系统地评估 SA。ClinicalTrials.gov 标识符：NCT02020642。我们建议在肾脏 Tx 之前和之后系统地评估 SA。ClinicalTrials.gov 标识符：NCT02020642。我们建议在肾脏 Tx 之前和之后系统地评估 SA。ClinicalTrials.gov 标识符：NCT02020642。