Annals of medicine 2017 03 10() 1-27 doi 10.1080/07853890.2017.1306100
Diabetes-associated kidney disease is characterized by impairment of renal function and albuminuria. The aim of the present study was to assess whether sleep-disordered breathing is associated with decreased estimated glomerular filtration rate or increased urine-albumin-to-creatinine-ratio independently from known modulators of diabetes-associated kidney disease.
MATERIAL AND METHODS
Estimated glomerular filtration rate and urine-albumin-to-creatinine-ratio were determined in the baseline survey of the DIACORE-SDB substudy, a prospectively planned study of Diabetes mellitus 2 patients. Apnea-hypopnea-index as a measure of the severity of sleep-disordered breathing was assessed using a 2-channel ambulatory SDB-monitoring device.
679 patients (mean age 66 years, men 61%, mean body-mass-index 31.2 kg/m(2)) were analyzed. In multivariable linear regression models adjusting for known modulators of diabetes-associated kidney disease such as sex, age, body-mass-index, systolic blood pressure, duration of diabetes and HbA1c, apnea-hypopnea-index [Beta-estimate -0.2ml/min/1.73m(2), 95%-CI(-0.3; -0.1), p = 0.004], duration of diabetes and age were associated with estimated glomerular filtration rate. Apnea-hypopnea-index [Beta-estimate 0.01mg/g, 95%-CI(0.00; 0.02), p = 0.009], duration of diabetes, HbA1c and systolic blood pressure were associated with ln(urine-albulmin-to-creatinine-ratio).
In patients with diabetes mellitus type 2, more severe sleep-disordered breathing is significantly associated with lower estimated glomerular filtration rate and increased albuminuria, independently of known modulators of diabetes-associated kidney disease.