Sleep-disordered breathing changes after kidney transplantation:a polysomnographic study

Background: Sleep disorders are common in patients with end-stage renal disease (ESRD) and are not improved by either conventional haemodialysis or peritoneal dialysis. Sleep-disordered breathing (SDB) is associated with cardiovascular disease and contributes to high mortality found in patients with ESRD. Cure of SDB after transplantation has been anecdotally reported. Methods: Thirty-four non-diabetic patients with ESRD were studied, and clinical, laboratory test and polysomnographic features were determined and compared prior to and after transplantation and between groups with or without SDB, defined as having an apnoea–hypopnoea index (AHI) ≥5. Results: An AHI ≥5 was present in nine patients (26.5%) prior to and seven (21%) after transplantation, and no significant reduction of mean AHI was found between study phases (5.3 ± 7.3 vs 3.1 ± 4.5; P > 0.05). Transplantation was associated with a significant improvement in sleep architecture. Conclusions: Kidney transplantation is associated with an improvement in sleep architecture, but does not cure SDB in all patients.