Objective To investigate the prevalence and risk factors of sleep-disordered breathing (SDB) in patients with different severity of chronic kidney diseases (CKD). Methods A total of 144 patients of non-dialysis CKD patients in nephrology unit were recruited in the study. The patients were divided into CKD 1-2 period, CKD 3-4 period, and CKD5 period according to the severity of renal function. Results The prevalence of moderate SDB in CKD 1-2 period, CKD 3-4 period and CKD5 period were 30.0%, 53.5% and 60.5%, respectively (P=0.03), the prevalence of nocturnal hypoxemia were 23.3%, 56.3% and 65.1%, respectively ( P=0.001), and the prevalence of excessive daytime sleepiness (EDS) were 33.3%, 57.7% and 62.8%, respectively (P=0.032). Logistic regression analysis showed that age, male, body mass index (BMI), hypertension, diabetes and heart failure were independent risk factors for CKD merged with moderate to severe SDB, and the highest risk factor was heart failure (OR=7.034, 95%CI 1.255-39.420). Compared with CKD 1-2 period and CKD 3-4 period, the risk degree of CKD5 period was higher (OR=3.569 95%CI 1.324-9.620). Correlation analysis showed that glomerular filtration rate (eGFR) was negatively correlated with sleep apnea-hypopnea index (AHI) (r=–0.327, P=0.000). Conclusions There is a high prevalence of SDB (predominantly obstructive) in CKD patients and the increased risk of SDB is significantly associated with decreased eGFR among these patients. Associated comorbidities in CKD patients, especially for cardiac dysfunction, are important risk factors for SDB.
Neuromuscular disease (NMD) encompasses a group of disorders that affect motor neurons, peripheral nerves, neuromuscular junctions, and skeletal muscles, potentially leading to respiratory muscle impairment and decline in respiratory function, significantly impacting patients' quality of life. In March 2023, clinical practice guideline titled Respiratory Management of Patients with Neuromuscular Weakness was released by the American College of Chest Physicians. This article summarizes, categorizes, and interprets the contents and key points of the guideline, aiming to provide more targeted guidance for clinical healthcare professionals and ultimately enhance the effectiveness of respiratory management for patients with NMD.