• Fernandes Julia Freitas Rodrigues JFR Post Graduation Program in Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Rio de Janeiro, Brazil., Barreto Silva Maria Inês MI Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil., Claudio Pinheiro Loivos, Ana Paula Medeiros Menna Barreto, Vagner da Silva Meira, Sergio Emanuel Kaiser, Rachel Bregman, and Klein Márcia Regina Simas Torres MRST Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil. Electronic address: m.
• Post Graduation Program in Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Rio de Janeiro, Brazil.
• Nutrition. 2019 Jan 1; 57: 282-289.

ObjectivesObstructive sleep apnea (OSA) is a risk factor for cardiovascular disease (CVD), the main cause of mortality in chronic kidney disease (CKD). Although the prevalence of OSA in patients with CKD has not been established, a few studies suggest that it is higher than in the general population, potentially increasing the risk for CVD. Obesity increases the risk, whereas sarcopenia has been suggested as a consequence of OSA in the general population. To our knowledge, these associations have not been adequately evaluated in patients with CKD. The aim of this study was to evaluate OSA frequency and its association with total and upper body adiposity and sarcopenia in non-dialyzed CKD patients.MethodsThis cross-sectional study included 73 patients with stages 3b-4 CKD (42 men, 62.9 ± 1.1 y of age). Glomerular filtration rate was estimated by the CKD-Epidemiology Collaboration equation. Patients were assessed for OSA by Watch-PAT200 (apnea-hypopnea index ≥5 events hourly; Itamar Medical), total body adiposity by dual-energy x-ray absorptiometry (DXA) and body mass index (BMI), upper body adiposity by anthropometric parameters and by trunk and visceral fat by DXA, and sarcopenia.ResultsOSA frequency was 67% (N = 49). Both total and upper body adiposity were associated with the presence and severity of OSA. In non-obese patients (BMI <30 kg/m2), upper body obesity increased significantly the frequency of OSA. OSA association with sarcopenia was blunted when BMI was included in regression model.ConclusionsResults from the present study suggest that in non-dialyzed CKD patients OSA is very common and associated with total and upper body obesity, but not with sarcopenia.Copyright © 2019 Elsevier Ltd. All rights reserved.

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