Mallamaci F, Leonardis D, Tripepi R, Parlongo G, Catalano C, Tripepi G, Castronovo V, Ferini-Strambi L, Zoccali C
CNR-IBIM, Clinical Epidemiology and Physiopathology of Renal Disease and Hypertension and Nephrology Unit-Azienda Ospedaliera 'Bianchi-Melacrino-Morelli' of Reggio Calabria, Italy.
Am J Transplant. 2009 Jun;9(6):1373-81. doi: 10.1111/j.1600-6143.2009.02653.x. Epub 2009 May 20.
Sleep disordered breathing (SDB) is a prevalent, important nontraditional cardiovascular (CV) risk factor in end-stage renal disease patients. The prevalence of SDB in renal transplant patients is unknown. We compared polysomnographic studies in 163 transplant patients with matched samples in the general population and explored longitudinally the effect of return to dialysis after graft failure on SDB in three consecutive cases. Episodes of nocturnal hypoxemia, average and minimal O(2) saturation overnight in transplant patients did not differ from those in individuals in the general population matched for age, gender and body mass index (BMI). The prevalence of moderate-to-severe SBD in these patients did not exceed the estimated prevalence of the same disturbance in the general population. The respiratory disturbance index in transplant patients was directly associated with BMI (p < 0.001). In the longitudinal study all indicators of SDB coherently increased after transplant failure. The prevalence of SDB in transplant patients does not differ from that in well-matched individuals in the general population. The favorable effect of renal transplantation on CV risk may be at least partially explained by the lack of risk excess for SDB in this population. Longitudinal observations after transplant failure are compatible with the hypothesis that renal transplantation reverses SDB.
睡眠呼吸障碍（SDB）是终末期肾病患者中一种普遍且重要的非传统心血管（CV）危险因素。肾移植患者中SDB的患病率尚不清楚。我们比较了163例移植患者与普通人群中匹配样本的多导睡眠图研究，并对连续3例移植失败后恢复透析对SDB的影响进行了纵向研究。移植患者夜间低氧血症发作、夜间平均和最低氧饱和度与年龄、性别和体重指数（BMI）相匹配的普通人群个体无差异。这些患者中中重度SBD的患病率未超过普通人群中相同障碍的估计患病率。移植患者的呼吸紊乱指数与BMI直接相关（p<0.001）。在纵向研究中，移植失败后SDB的所有指标均一致升高。移植患者中SDB的患病率与普通人群中匹配良好的个体无差异。肾移植对心血管风险的有利影响可能至少部分是由于该人群中SDB风险没有增加。移植失败后的纵向观察结果与肾移植可逆转SDB这一假设相符。
