43 - Sleep Related Breathing Disorders and Cardiometabolic Risk Factors in Pediatric Kidney Transplant Patients

Poster Number: 43
Publication Number: 43.235

Anna Kuznetsova, Cohen Children's Medical Center, Bellmore, NY, United States; Kevin E. Meyers, The Children's Hospital of Philadelphia and University of Pennsylvania, Drexel Hill, PA, United States; Preeta Dhanantwari, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, United States; Nina Laney, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Christine Sethna, Cohen Children's Medical Center, New Hyde Park, NY, United States

Background: In the general pediatric population, sleep related breathing disorders (SRBDs) are associated with increased odds of hypertension and dyslipidemia, while in adults, SRBDs increase risk of heart failure and stroke. Although cardiovascular disease is the leading cause of morbidity and mortality in kidney transplant patients, few studies have investigated the association between SRBDs and cardiometabolic risk factors in pediatric kidney transplant recipients.

Objective: To determine whether SRBDs are associated with cardiometabolic risk factors in pediatric kidney transplant recipients.

Design/Methods: A prospective cohort study of pediatric kidney transplant recipients using baseline cardiometabolic data from a previous clinical trial (NCT01007994) was conducted. Guardians of pediatric kidney transplant recipients completed a validated 22-item pediatric sleep questionnaire (Chervin) that is both sensitive and specific for detecting SRBDs. A higher score indicated poorer sleep and a score greater than 33% was used as demarcation for the diagnosis of a SRBD. Linear and logistic regression models adjusted for age, sex and race were used to determine associations between sleep score/SRBDs and cardiometabolic risk factors (body mass index [BMI], ambulatory blood pressure index, nocturnal dipping, left ventricular mass index [LVMI], left ventricular hypertrophy [LVH], ejection fraction, pulse wave velocity [PWV], fasting lipids, FGF-23 and vitamin D).

Results: Demographic and clinical characteristics of the 54 transplant recipients enrolled are presented in Table 1. The prevalence of SRBDs was 26.0% (n=14). Participants with SRBDs had significantly higher median BMI z-scores and did not take antihypertensive medications in the evening compared to those without SRBDs. A higher sleep score and the presence of a SRBD were both associated with multiple cardiometabolic risk factors including greater BMI z-score, total cholesterol level, triglyceride level, LDL level, LVMI and greater odds of LVH when adjusted for age, sex, and race (Table 2).Conclusion(s): In alignment with previously reported associations in the general pediatric and chronic kidney disease populations, the study found that SRBD was associated with increased cardiometabolic risk in pediatric kidney transplant recipients. It may be beneficial to screen pediatric kidney transplant patients for the presence of SRBDs to mitigate morbidity and mortality following kidney transplant.
Anna Kuznetsova CVPAS Resume Anna Kuznetsova 2021.pdf

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