Snoring and Self-Reported Apnea Are Risk Factors for Albuminuria and CKD: A Retrospective Data Analysis

Background: Obstructive sleep apnea is a well-known cause of albuminuria. However, many patients are reluctant to undergo a sleep apnea study due to the time and effort involved, often requiring significant persuasion. It would be beneficial if there is some data to demonstrate to patients that snoring or episodes of sleep apnea are linked to chronic kidney disease. In this study, we present a retrospective data analysis comparing the effects of snoring and self-reported apnea episodes on albuminuria. Methods: We conducted data analysis of a retrospective survey from 2017-2020 pre-pandemic using National Health and Nutrition Examination Survey (NHANES). We explored variables for sleep disturbance such as self-reporting snoring, and episodes of apena and compared it with Urine albumin and creatinine ratio (UACR). All the demographic variables were included for participants above 20 years of age and data was alanlyzed on 9,232 adults using Stata software. Results: Episodes of apnea were seen higher in age group of 45-65 years (53.51%). Similarly, episodes of snoring seen higher in the same age group 50.48%, followed by 25.39 % in age group 20-40 years. Snoring and apneic events were higher in males 53.97% and 58.57 % respectively. About 58.42 % of individuals with episodes of apnea and 61.27 % with snoring slept between 7 to 9 hours. Unadjusted logistic regression for episodes of apnea showed 1.34 OR with p value 0.003 for UACR OF 30-299 mg, 1.77OR with p value of 0.002 for UACR of >300 mg/dl. Unadjusted logistic regression for snoring showed 1.19 OR with p value 0.011 for UACR OF 30-299 mg, 1.57 OR with p value of 0.002 for UACR of >300 mg/dl. When adjusted for diabetes and hypertension the results for episodes of apnea showed 1.04 OR for 30-299mg/dl, 1.15 OR for >300mg/dl. Conclusion: Our study adds to the body of data that sleep disturbances are strongly associated with albuminuria and develpment of chronic kidney disease. We recommemd primary care physicians to check albuminuria in patients with history of snoring and episodes of sleep apnea with timely referral to nephrologist to improve Kidney health.