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Does Kidney Transplantation Affect Sleep and Fatigue in Patients With Kidney Disease?
Sleep disorders and fatigue are highly prevalent in chronic kidney disease (CKD) and end-stage kidney disease (ESKD) patients but there is limited evidence on the effect of kidney transplant (KTx) on these. In a prospective cohort study of patients with advanced CKD (estimated glomerular filtration...
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| Published in: | Transplantation direct 2019-06, Vol.5 (6), p.e461-e461 |
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| container_title | Transplantation direct |
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| creator | Tandukar, Srijan Hou, Surui Yabes, Jonathan Ran, Xinhui Fletcher, Mary Strollo, Patrick Patel, Sanjay R. Unruh, Mark Jhamb, Manisha |
| description | Sleep disorders and fatigue are highly prevalent in chronic kidney disease (CKD) and end-stage kidney disease (ESKD) patients but there is limited evidence on the effect of kidney transplant (KTx) on these.
In a prospective cohort study of patients with advanced CKD (estimated glomerular filtration rate |
| doi_str_mv | 10.1097/TXD.0000000000000895 |
| format | article |
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In a prospective cohort study of patients with advanced CKD (estimated glomerular filtration rate<30 mL/min/1.73 m
) or ESKD, polysomnography and patient-reported symptom assessments were conducted. Pre- and post-KTx changes in sleep apnea (SA) severity (measured by apnea hypopnea index [AHI]) were analyzed and compared with patients who did not receive KTx. Regression models were used to examine predictors of SA severity.
Among 77 patients (mean age 51 y, BMI 29 kg/m
, 66% males, 23% ESKD), 61% had SA at baseline. Among 39 KTx recipients, 56% had SA, with 39% having moderate-severe SA after 10 ± 5.6 months post-KTx. There was no difference in AHI in either the KTx (median 6 versus 8;
= 0.37) or no-KTx (median 15 versus 16;
= 0.61) groups after an average of 19.9 ± 8.9 months. KTx led to significant clinically meaningful improvements in fatigue and health-related quality of life (adjusted effect size 0.3-0.6). In multivariable regression, baseline AHI was the only significant predictor of SA severity (adjusted β = 3.6/5 units, 95% confidence interval 2.1, 5.2) after adjusting for KTx status, age, sex, and body mass index.
More than half of the KTx recipients had SA. There was no significant change in SA severity with KTx. Clinically meaningful moderate size improvements in patient-reported fatigue and health-related quality of life may be seen with KTx.</description><identifier>ISSN: 2373-8731</identifier><identifier>EISSN: 2373-8731</identifier><identifier>DOI: 10.1097/TXD.0000000000000895</identifier><identifier>PMID: 31321295</identifier><language>eng</language><publisher>United States: The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc</publisher><subject>Kidney Transplantation</subject><ispartof>Transplantation direct, 2019-06, Vol.5 (6), p.e461-e461</ispartof><rights>The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2019 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5193-fb4f21ba13c073135a875c923d76f6b63b41ee7e61e19ce30d1233a031b3c6523</citedby><cites>FETCH-LOGICAL-c5193-fb4f21ba13c073135a875c923d76f6b63b41ee7e61e19ce30d1233a031b3c6523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553622/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553622/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31321295$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tandukar, Srijan</creatorcontrib><creatorcontrib>Hou, Surui</creatorcontrib><creatorcontrib>Yabes, Jonathan</creatorcontrib><creatorcontrib>Ran, Xinhui</creatorcontrib><creatorcontrib>Fletcher, Mary</creatorcontrib><creatorcontrib>Strollo, Patrick</creatorcontrib><creatorcontrib>Patel, Sanjay R.</creatorcontrib><creatorcontrib>Unruh, Mark</creatorcontrib><creatorcontrib>Jhamb, Manisha</creatorcontrib><title>Does Kidney Transplantation Affect Sleep and Fatigue in Patients With Kidney Disease?</title><title>Transplantation direct</title><addtitle>Transplant Direct</addtitle><description>Sleep disorders and fatigue are highly prevalent in chronic kidney disease (CKD) and end-stage kidney disease (ESKD) patients but there is limited evidence on the effect of kidney transplant (KTx) on these.
In a prospective cohort study of patients with advanced CKD (estimated glomerular filtration rate<30 mL/min/1.73 m
) or ESKD, polysomnography and patient-reported symptom assessments were conducted. Pre- and post-KTx changes in sleep apnea (SA) severity (measured by apnea hypopnea index [AHI]) were analyzed and compared with patients who did not receive KTx. Regression models were used to examine predictors of SA severity.
Among 77 patients (mean age 51 y, BMI 29 kg/m
, 66% males, 23% ESKD), 61% had SA at baseline. Among 39 KTx recipients, 56% had SA, with 39% having moderate-severe SA after 10 ± 5.6 months post-KTx. There was no difference in AHI in either the KTx (median 6 versus 8;
= 0.37) or no-KTx (median 15 versus 16;
= 0.61) groups after an average of 19.9 ± 8.9 months. KTx led to significant clinically meaningful improvements in fatigue and health-related quality of life (adjusted effect size 0.3-0.6). In multivariable regression, baseline AHI was the only significant predictor of SA severity (adjusted β = 3.6/5 units, 95% confidence interval 2.1, 5.2) after adjusting for KTx status, age, sex, and body mass index.
More than half of the KTx recipients had SA. There was no significant change in SA severity with KTx. Clinically meaningful moderate size improvements in patient-reported fatigue and health-related quality of life may be seen with KTx.</description><subject>Kidney Transplantation</subject><issn>2373-8731</issn><issn>2373-8731</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpdkcFu1DAQhiMEolXpGyCUI5cUj8d24guo6lKoqAQSW8HNsp3Jrks22dpZqr49XrYtW3zxaDzzzT_-i-I1sBNgun43_zk7Yfun0fJZccixxqqpEZ7vxQfFcUrXuQaEUoLjy-IAATlwLQ-Lq9lIqfwS2oHuynm0Q1r3dpjsFMahPO068lP5vSdal3Zoy_OcX2yoDEP5LYc0TKn8EablA2AWEtlEH14VLzrbJzq-v4-Kq_OP87PP1eXXTxdnp5eVl6Cx6pzoODgL6FkWitI2tfSaY1urTjmFTgBRTQoItCdkLXBEyxAceiU5HhUXO2472muzjmFl450ZbTB_E2NcGBun4HsyNWBN2jmnmBaNFFZ6JA4kuHDY8Saz3u9Y641bUevzctH2T6BPX4awNIvxt1FSouJbMW_vAXG82VCazCokT33-Txo3yXCugAte6-0ssSv1cUwpUvc4BpjZGmyyweZ_g3Pbm32Jj00Pdv7j3o79RDH96je3FM2SbD8tDYNGSM6bijPQTGVotSUj_gE7fa8m</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>Tandukar, Srijan</creator><creator>Hou, Surui</creator><creator>Yabes, Jonathan</creator><creator>Ran, Xinhui</creator><creator>Fletcher, Mary</creator><creator>Strollo, Patrick</creator><creator>Patel, Sanjay R.</creator><creator>Unruh, Mark</creator><creator>Jhamb, Manisha</creator><general>The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc</general><general>Wolters Kluwer Health</general><general>Wolters Kluwer</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20190601</creationdate><title>Does Kidney Transplantation Affect Sleep and Fatigue in Patients With Kidney Disease?</title><author>Tandukar, Srijan ; Hou, Surui ; Yabes, Jonathan ; Ran, Xinhui ; Fletcher, Mary ; Strollo, Patrick ; Patel, Sanjay R. ; Unruh, Mark ; Jhamb, Manisha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5193-fb4f21ba13c073135a875c923d76f6b63b41ee7e61e19ce30d1233a031b3c6523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Kidney Transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tandukar, Srijan</creatorcontrib><creatorcontrib>Hou, Surui</creatorcontrib><creatorcontrib>Yabes, Jonathan</creatorcontrib><creatorcontrib>Ran, Xinhui</creatorcontrib><creatorcontrib>Fletcher, Mary</creatorcontrib><creatorcontrib>Strollo, Patrick</creatorcontrib><creatorcontrib>Patel, Sanjay R.</creatorcontrib><creatorcontrib>Unruh, Mark</creatorcontrib><creatorcontrib>Jhamb, Manisha</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Transplantation direct</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tandukar, Srijan</au><au>Hou, Surui</au><au>Yabes, Jonathan</au><au>Ran, Xinhui</au><au>Fletcher, Mary</au><au>Strollo, Patrick</au><au>Patel, Sanjay R.</au><au>Unruh, Mark</au><au>Jhamb, Manisha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does Kidney Transplantation Affect Sleep and Fatigue in Patients With Kidney Disease?</atitle><jtitle>Transplantation direct</jtitle><addtitle>Transplant Direct</addtitle><date>2019-06-01</date><risdate>2019</risdate><volume>5</volume><issue>6</issue><spage>e461</spage><epage>e461</epage><pages>e461-e461</pages><issn>2373-8731</issn><eissn>2373-8731</eissn><abstract>Sleep disorders and fatigue are highly prevalent in chronic kidney disease (CKD) and end-stage kidney disease (ESKD) patients but there is limited evidence on the effect of kidney transplant (KTx) on these.
In a prospective cohort study of patients with advanced CKD (estimated glomerular filtration rate<30 mL/min/1.73 m
) or ESKD, polysomnography and patient-reported symptom assessments were conducted. Pre- and post-KTx changes in sleep apnea (SA) severity (measured by apnea hypopnea index [AHI]) were analyzed and compared with patients who did not receive KTx. Regression models were used to examine predictors of SA severity.
Among 77 patients (mean age 51 y, BMI 29 kg/m
, 66% males, 23% ESKD), 61% had SA at baseline. Among 39 KTx recipients, 56% had SA, with 39% having moderate-severe SA after 10 ± 5.6 months post-KTx. There was no difference in AHI in either the KTx (median 6 versus 8;
= 0.37) or no-KTx (median 15 versus 16;
= 0.61) groups after an average of 19.9 ± 8.9 months. KTx led to significant clinically meaningful improvements in fatigue and health-related quality of life (adjusted effect size 0.3-0.6). In multivariable regression, baseline AHI was the only significant predictor of SA severity (adjusted β = 3.6/5 units, 95% confidence interval 2.1, 5.2) after adjusting for KTx status, age, sex, and body mass index.
More than half of the KTx recipients had SA. There was no significant change in SA severity with KTx. Clinically meaningful moderate size improvements in patient-reported fatigue and health-related quality of life may be seen with KTx.</abstract><cop>United States</cop><pub>The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc</pub><pmid>31321295</pmid><doi>10.1097/TXD.0000000000000895</doi><oa>free_for_read</oa></addata></record> |
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| source | Open Access: PubMed Central; Lippincott Williams & Wilkins |
| subjects | Kidney Transplantation |
| title | Does Kidney Transplantation Affect Sleep and Fatigue in Patients With Kidney Disease? |
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