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Nonapnea Sleep Disorders and the Risk of Acute Kidney Injury: A Nationwide Population-Based Study
Hugo You-Hsien Lin1, Kai-Ting Chang, Yu-Han Chang
1From the Division of Nephrology (HY-HL, C-CH, M-CK, S-JH), Department of Internal Medicine; Neurology (C-YH), Kaohsiung Medical University Hospital, Kaohsiung Medical University; Department of Internal Medicine (HY-HL, Y-HC); Pediatrics (K-TC); Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University (J-HT); Graduate Institute of Medicine (HY-HL, C-SL, S-JH), College of Medicine, Kaohsiung Medical University; Renal Division (TL), Brigham and Women's Hospital, Harvard Medical School; Lipid Science and Aging Research Center (C-JL), Kaohsiung Medical University; Center for Lipid Bioscience (C-JL), Kaohsiung Medical University Hospital; Department of Sports Medicine (D-CW), Kaohsiung Medical University, Kaohsiung City; and Institute of Population Sciences (S-JH), National Health Research Institutes, Miaoli, Taiwan.
Abstract:
Nonapnea sleep disorders (NASDs) and associated problems, which are highly prevalent in patients with kidney diseases, are associated with unfavorable medical sequelae. Nonetheless, whether NASDs are associated with acute kidney injury (AKI) development has not been thoroughly analyzed. We examined the association between NASD and AKI. We conducted a population-based study by using 1,000,000 representative data from the Taiwan National Health Insurance Research Database for the period from January 1, 2000, to December 31, 2010. We studied the incidence and risk of AKI in 9178 newly diagnosed NASD patients compared with 27,534 people without NASD matched according to age, sex, index year, urbanization level, region of residence, and monthly income at a 1:3 ratio. The NASD cohort had an adjusted hazard ratio (hazard ratio [HR]; 95% confidence interval [CI] = 1.15-2.63) of subsequent AKI 1.74-fold higher than that of the control cohort. Older age and type 2 diabetes mellitus were significantly associated with an increased risk of AKI (P < 0.05). Among different types of NASDs, patients with insomnia had a 120% increased risk of developing AKI (95% CI = 1.38-3.51; P = 0.001), whereas patients with other sleep disorders had a 127% increased risk of subsequent AKI (95% CI = 1.07-4.80; P = 0.033). Men with NASDs were at a high risk of AKI (P < 0.05). This nationwide population-based cohort study provides evidence that patients with NASDs are at higher risk of developing AKI than people without NASDs.
