Objectives: Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular morbidity in the general population. The clinical significance of OSA among kidney transplant patients is unknown. Our aim was to investigate the association of "high risk of OSA" with death-censored graft loss and mortality in a large cohort of kidney transplant recipients.
Patients And Methods: Using the Berlin questionnaire 1067 prevalent kidney transplant recipients were assessed for risk of OSA. Socio-demographic variables, laboratory parameters and data about graft loss and mortality were obtained from the medical records. Multivariable-adjusted associations of OSA risk with graft loss and with all-cause mortality was assessed in competing-risks regression models.
Results: Of the 823 patients who completed the Berlin questionnaire 28% had high risk of OSA (HRO) at baseline. Patients with HRO were older (52±11 vs. 47±13years, p<0.001), had a higher prevalence of diabetes (22 vs. 15%, p=0.018), worse baseline kidney function (estimated glomerular filtration rate: 46±18 vs. 51±19ml/min/1.73m(2), p=0.001) and higher BMI (27±5 vs. 24±4kg/m(2), p<0.001). In multivariate models HRO was an independent predictor of graft loss among females after adjusting for age, comorbidity, hypertension, BMI, kidney function, duration of chronic kidney disease, other laboratory parameters and transplant-related data (HR=3.05; CI: 1.24-7.51; p=0.015), while HRO did not predict graft survival among males. HRO at baseline was not independently associated with all-cause mortality in the sample.
Conclusion: High risk of OSA is an independent predictor of graft loss among female kidney transplant patients.
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http://dx.doi.org/10.1016/j.sleep.2010.08.012 | DOI Listing |
JAMA Otolaryngol Head Neck Surg
January 2025
Department of General, Visceral, and Endocrine Surgery, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
Am J Sports Med
January 2025
Mayo Clinic Arizona Department of Orthopedic Surgery, Phoenix, Arizona, USA.
Background: The Latarjet and other bony augmentation procedures are commonly used to treat anterior shoulder instability in the setting of significant glenoid bone loss. Although several fixation strategies have been reported, the biomechanical strength of these techniques remains poorly understood.
Purpose: To perform a systematic review of the biomechanical strength of glenoid bony augmentation procedures for anterior shoulder instability.
J Phys Chem Lett
January 2025
Molecular Materials and Nanosystems & Institute for Complex Molecular Systems, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands.
Reducing nonradiative recombination is crucial for minimizing voltage losses in metal-halide perovskite solar cells and achieving high power conversion efficiencies. Photoluminescence spectroscopy on complete or partial perovskite solar cell stacks is often used to quantify and disentangle bulk and interface contributions to nonradiative losses. Accurately determining the intrinsic loss in a perovskite layer is key to analyzing the origins of nonradiative recombination and developing defect engineering strategies.
View Article and Find Full Text PDFTransplantation
January 2025
Hepatobiliary Surgery and Liver Transplantation Unit, Hospital Universitario Reina Sofía, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain.
Background: Several scores have been developed to stratify the risk of graft loss in controlled donation after circulatory death (cDCD). However, their performance is unsatisfactory in the Spanish population, where most cDCD livers are recovered using normothermic regional perfusion (NRP). Consequently, we explored the role of different machine learning-based classifiers as predictive models for graft survival.
View Article and Find Full Text PDFNat Med
January 2025
Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Up to 50-70% of patients with liver cirrhosis develop hepatic encephalopathy (HE), which is closely related to gut microbiota dysbiosis, with an unclear mechanism. Here, by constructing gut-brain modules to assess bacterial neurotoxins from metagenomic datasets, we found that phenylalanine decarboxylase (PDC) genes, mainly from Ruminococcus gnavus, increased approximately tenfold in patients with cirrhosis and higher in patients with HE. Cirrhotic, not healthy, mice colonized with R.
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