Effect of obstructive sleep apnoea syndrome combined with renal insufficiency on all-cause mortality in elderly patients in China: a prospective cohort study

Objective We hypothesised that all-cause mortality in elderly patients with obstructive sleep apnoea syndrome (OSAS) was associated with renal insufficiency.Design A cohort study.Setting A prospective study of patients with OSAS enrolled in sleep centres/departments in multicentre hospitals in China...

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Main Authors: Lin Liu, Zhe Zhao, Yinghui Gao, Fengfeng Fang, Zuo Zhang, Libo Zhao, Zijun He, Kailiang Li, Hongyan Bian
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/7/e086515.full
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author Lin Liu
Zhe Zhao
Yinghui Gao
Fengfeng Fang
Zuo Zhang
Libo Zhao
Zijun He
Kailiang Li
Hongyan Bian
author_facet Lin Liu
Zhe Zhao
Yinghui Gao
Fengfeng Fang
Zuo Zhang
Libo Zhao
Zijun He
Kailiang Li
Hongyan Bian
author_sort Lin Liu
collection DOAJ
description Objective We hypothesised that all-cause mortality in elderly patients with obstructive sleep apnoea syndrome (OSAS) was associated with renal insufficiency.Design A cohort study.Setting A prospective study of patients with OSAS enrolled in sleep centres/departments in multicentre hospitals in China from 2015 to 2017.Participants A total of 1290 patients with OSAS from six tertiary comprehensive hospitals in China were included in this study; of these, 1076 patients were included in the analysis based on inclusion and exclusion criteria.Main outcome measures All-cause death events were the main adverse outcomes.Result During a median follow-up of 42 months, 50 patients (4.6%) died, including 24 (2.2%) cardiovascular deaths. The incidence of all-cause death and cardiovascular death was higher in patients with estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73 m2 than in the other groups (p<0.001). Multivariate Cox regression models showed that patients with low levels of eGFR had a higher risk of all-cause death compared with patients with high levels of eGFR (HR=8.954, 95% CI, 2.108 to 38.033; p=0.003) and cardiovascular death risk (HR=4.163, 95% CI, 1.524 to 11.375; p=0.005).Conclusion The incidence of all-cause death and cardiovascular death events increased with decreasing renal function in elderly patients with OSAS and was higher in patients with end-stage renal insufficiency. The risk of all-cause and cardiovascular deaths was highest at eGFR below 30 mL/min/1.73 m2.
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spelling doaj-art-36678a6190ff4f02a3e5d28fec6ed2632025-08-20T03:32:23ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-086515Effect of obstructive sleep apnoea syndrome combined with renal insufficiency on all-cause mortality in elderly patients in China: a prospective cohort studyLin Liu0Zhe Zhao1Yinghui Gao2Fengfeng Fang3Zuo Zhang4Libo Zhao5Zijun He6Kailiang Li7Hongyan Bian8Department of Pulmonary and Critical Care Medicine of the Second Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Vasculocardiology, Second Medical Center, Chinese PLA General Hospital, Beijing, ChinaPeking University International Hospital, Beijing, ChinaChinese PLA General Hospital, Beijing, ChinaPeople’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, ChinaDepartment of Vasculocardiology, Second Medical Center, Chinese PLA General Hospital, Beijing, ChinaMedical College, Yan’an University, Yan’an, Shaanxi, ChinaHealth Service Department of the Guard Bureau of the General Office of the Central Committee of the Communist Party of China, Communist Party of China General Office of the Central Committee Security Bureau, Beijing, ChinaMedical College, Yan’an University, Yan’an, Shaanxi, ChinaObjective We hypothesised that all-cause mortality in elderly patients with obstructive sleep apnoea syndrome (OSAS) was associated with renal insufficiency.Design A cohort study.Setting A prospective study of patients with OSAS enrolled in sleep centres/departments in multicentre hospitals in China from 2015 to 2017.Participants A total of 1290 patients with OSAS from six tertiary comprehensive hospitals in China were included in this study; of these, 1076 patients were included in the analysis based on inclusion and exclusion criteria.Main outcome measures All-cause death events were the main adverse outcomes.Result During a median follow-up of 42 months, 50 patients (4.6%) died, including 24 (2.2%) cardiovascular deaths. The incidence of all-cause death and cardiovascular death was higher in patients with estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73 m2 than in the other groups (p<0.001). Multivariate Cox regression models showed that patients with low levels of eGFR had a higher risk of all-cause death compared with patients with high levels of eGFR (HR=8.954, 95% CI, 2.108 to 38.033; p=0.003) and cardiovascular death risk (HR=4.163, 95% CI, 1.524 to 11.375; p=0.005).Conclusion The incidence of all-cause death and cardiovascular death events increased with decreasing renal function in elderly patients with OSAS and was higher in patients with end-stage renal insufficiency. The risk of all-cause and cardiovascular deaths was highest at eGFR below 30 mL/min/1.73 m2.https://bmjopen.bmj.com/content/15/7/e086515.full
spellingShingle Lin Liu
Zhe Zhao
Yinghui Gao
Fengfeng Fang
Zuo Zhang
Libo Zhao
Zijun He
Kailiang Li
Hongyan Bian
Effect of obstructive sleep apnoea syndrome combined with renal insufficiency on all-cause mortality in elderly patients in China: a prospective cohort study
BMJ Open
title Effect of obstructive sleep apnoea syndrome combined with renal insufficiency on all-cause mortality in elderly patients in China: a prospective cohort study
title_full Effect of obstructive sleep apnoea syndrome combined with renal insufficiency on all-cause mortality in elderly patients in China: a prospective cohort study
title_fullStr Effect of obstructive sleep apnoea syndrome combined with renal insufficiency on all-cause mortality in elderly patients in China: a prospective cohort study
title_full_unstemmed Effect of obstructive sleep apnoea syndrome combined with renal insufficiency on all-cause mortality in elderly patients in China: a prospective cohort study
title_short Effect of obstructive sleep apnoea syndrome combined with renal insufficiency on all-cause mortality in elderly patients in China: a prospective cohort study
title_sort effect of obstructive sleep apnoea syndrome combined with renal insufficiency on all cause mortality in elderly patients in china a prospective cohort study
url https://bmjopen.bmj.com/content/15/7/e086515.full
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