The following is a summary of “Contemporary Nationwide Trends in Major Adverse Cardiovascular and Cerebrovascular Events Among Elderly Chronic Kidney Disease Patients With versus Without Obstructive Sleep Apnea and Associated Sex and Racial Disparities, 2016-2019,” published in the November 2023 issue of Nephrology by Borra et al.

Patients with end-stage renal disease (ESRD) undergoing more intensive renal replacement therapy have demonstrated reduced severity of obstructive sleep apnea (OSA).

Researchers performed a retrospective study comparing the incidence and trends of combined cardiovascular events in geriatric CKD patients with and without OSA, focusing on geriatric CKD patients.

They utilized nationwide data (2016 to 2019) to identify geriatric CKD patients using ICD-10 codes. A comparative assessment was carried out between elderly CKD patients with and without OSA, exploring their baseline characteristics and potential disparities related to sex and race.

The results showed 14,157,877 geriatric CKD patients with more prevalent OSA in men (60.5% vs. 50.5%) and the white race (79.3% vs. 72.5%) compared to the non-OSA group. In the OSA group, men had an increased prevalence of major adverse cardiovascular and cerebrovascular events (MACCE) (12.0% vs. 9.7%) and acute myocardial infarction (AMI) (7.0% vs. 5.2%) with P<0.001. OSA patients experienced a decrease in all-cause mortality (3.2% vs. 4.7%), AMI (6.3% vs. 7.2%), and cardiac arrest (1.0% vs. 1.3%), with P<0.001. BiPAP/CPAP therapy was associated with significantly reduced odds of MACCE (P<0.001).

They concluded that in elderly CKD patients, OSA, regardless of BiPAP/CPAP use, was unexpectedly associated with lower MACCE rates, highlighting the need for further exploration of OSA-CKD interplay in managing cardiovascular outcomes.

Source: ahajournals.org/doi/10.1161/circ.148.suppl_1.15816