Prevalence of sleep disordered breathing in children with chronic kidney disease.

BACKGROUND

Sleep disordered breathing (SDB) is reported in nearly 62% of children with chronic kidney disease (CKD). We report the prevalence and severity of SDB in children with CKD stages 2-5 using polysomnography (PSG).

METHODS

This observational, cross-sectional study was conducted in the pediatric nephrology outpatient clinic and sleep medicine laboratory at a tertiary care center in south India from March to December 2023. We enrolled children aged 5-18 years, with CKD stage ≥ 2, including dialysis-dependent and 3 months post-kidney transplantation, and performed the Epworth Sleepiness Scale questionnaire for Children and Adolescents (ESS-CHAD) and PSG after obtaining informed consent. Age-specific values of apnea hypopnea index (AHI) were used to diagnose and measure obstructive sleep apnea (OSA). Comparisons between PSG indices were performed between children with early CKD (stage 2) and advanced CKD (stages 3 to 5 T).

RESULTS

Among the 36 patients (75% males) with CKD enrolled, even though only 2 (6%) clinically reported SDB as per ESS-CHAD, an overall prevalence of 47% of OSA was observed. Though increasing prevalence and severity was found with increasing stages of CKD, a significant proportion of patients with CKD 2 (50%) had OSA. Moderate to severe OSA was noted only in patients with advanced CKD.

CONCLUSION

SDB is prevalent in all stages of CKD in children, with greater severity in higher stages of CKD.