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Sleep-related breathing disorders and cardiometabolic risk factors in pediatric kidney transplant recipients
Anna Kuznetsova1, Kevin E Meyers2, Preeta Dhanantwari3
1Division of Nephrology, Department of Pediatrics, Cohen Children's Medical Center of New York, New Hyde Park, New York, USA.
Insights
Sleep-related breathing disorders (SRBDs) are linked to increased cardiometabolic risk in pediatric kidney transplant recipients. Early identification and management of SRBDs are crucial for improving cardiovascular health in these vulnerable patients.
Area of Science:
- Pediatric Nephrology
- Cardiology
- Sleep Medicine
Background:
- Sleep-related breathing disorders (SRBDs) are associated with cardiovascular disease, a leading cause of mortality in kidney transplant recipients.
- Limited research exists on the link between SRBDs and cardiometabolic risk factors in pediatric kidney transplant recipients.
Purpose of the Study:
- To investigate the association between SRBDs and cardiometabolic risk factors in pediatric kidney transplant recipients.
- To determine the prevalence of SRBDs in this population.
Main Methods:
- A cross-sectional study utilizing baseline cardiometabolic data from a clinical trial.
- Parents/guardians completed the 22-item Sleep-related Breathing Disorder (SRBD) questionnaire; a score >33% indicated SRBD diagnosis.
- Statistical analyses included Fisher's exact test, Mann-Whitney U test, and regression models.
Main Results:
- The prevalence of SRBDs was 26% among 58 pediatric kidney transplant recipients.
- SRBDs were significantly associated with elevated total cholesterol, LDL cholesterol, and triglyceride levels.
- SRBDs were also associated with left ventricular hypertrophy (LVH).
Conclusions:
- Sleep-related breathing disorders are associated with increased cardiometabolic risk in pediatric kidney transplant recipients.
- These findings align with observations in the general pediatric and chronic kidney disease populations.
- Further research and clinical attention to SRBDs in this cohort are warranted.
Background:
SRBDs have been shown to increase the risk of cardiovascular disease, which is a significant cause of mortality in kidney transplant recipients. Few studies have investigated the association between SRBDs and cardiometabolic risk factors in pediatric kidney transplant recipients.
Methods:
This was a cross-sectional study of pediatric kidney transplant recipients using baseline cardiometabolic data from a previous clinical trial (NCT01007994). Parents/guardians of pediatric kidney transplant recipients filled out 22-item PSQ. A score greater than 33% was defined as a diagnosis of a SRBD. Fisher's exact test, Mann-Whitney U test, and regressions were used to determine associations.
Results:
Among the 58 transplant recipients enrolled, 14.80% (n = 8) of participants identified as Black and 40.7% (n = 22) were male. The median age was 13 (IQR 8.25, 17) years and median number of years post-transplant for participants was 2 (IQR 1, 4). The prevalence of SRBDs was 26% (n = 14). The presence of a SRBD was associated with abnormalities in multiple cardiometabolic risk factors including total cholesterol level (β = 23.63; 95% CI 3.58-43.67), LDL level (β = 24.94; 95% CI 6.37-43.50), triglyceride level (β = 54.62; 95% CI 8.74-100.50), and LVH (OR = 5.12; 95% CI 1.12-23.45) when adjusted for age, sex, and race.
Conclusions:
Similar to associations reported in the general pediatric and general CKD populations, SRBD is associated with increased cardiometabolic risk in pediatric kidney transplant recipients.
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