Evidence map›Paper›PMID 30110675›Full record

Observational studyAmerican journal of nephrology2018

Obstructive Sleep Apnea Increases Sudden Cardiac Death in Incident Hemodialysis Patients.

Eric S Kerns, Esther D Kim, Lucy A Meoni, Stephen M Sozio, Bernard G Jaar, Michelle M Estrella, Rulan S Parekh, Ghada Bourjeily

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in American journal of nephrology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 6 pooled it
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 6 syntheses or guidelines pooled it, 31 citations in OpenAlex.

  1. Pooled it
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  7. Article
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  10. Type of arrhythmias and the risk of sudden cardiac death in dialysis patients: a systematic review and meta-analysis.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025
    Review
  11. Sleep-Disordered Breathing Destabilizes Ventricular Repolarization.medRxiv : the preprint server for health sciences · 2024
    Article
  12. Article
  13. Article
  14. Review
  15. Functional outcomes of sleep predict cardiovascular intermediary outcomes and all-cause mortality in patients on incident hemodialysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021
    Article
  16. Article
  17. Review
  18. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Eric S KernsDepartment of Medicine, Division of Nephrology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA.
Esther D KimDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Lucy A MeoniDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Stephen M SozioDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Bernard G JaarDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Michelle M EstrellaUniversity of California San Francisco, Kidney Health Research Collaborative, San Francisco, California, USA.
Rulan S ParekhDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Ghada BourjeilyDepartment of Medicine, Divisions of Pulmonary, Critical Care and Sleep Medicine, and Obstetric Medicine, The Miriam Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Johns Hopkins University · USHospital for Sick Children · CABrown University · USLahey Hospital and Medical Center · USUniversity of California, San Francisco · US

Funding

Longitudinal Study of DialysisR01DK072367 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI PAREKH, RULAN S · 2007 to 2011
$3.7M
Placental role in mediating adverse outcomes in obstructive sleep apneaR01HD078515 · NICHD · MIRIAM HOSPITAL · PI BOURJEILY, GHADA · 2014 to 2018
$2.7M
Predictors of de novo development of obstructive sleep apnea in pregnancyR01HL130702 · NHLBI · MIRIAM HOSPITAL · PI BOURJEILY, GHADA · 2016 to 2020
$2.6M
NHLBI NIH HHS R01 HL130702NICHD NIH HHS R01 HD078515NIDDK NIH HHS R01 DK072367
6 · The paper itself

Abstract

backgroundMortality in end-stage renal disease (ESRD) occurs predominantly from cardiovascular disease (CVD) and sudden cardiac death (SCD). Obstructive sleep apnea (OSA) is characterized by periodic airflow limitation associated with sleep arousal and oxygen desaturation and is prevalent in patients with ESRD. Whether OSA increases the risk for SCD, cardiovascular and all-cause mortality among hemodialysis patients remains unknown.

methodsIn a prospective cohort of 558 incident hemodialysis patients, we examined the association of OSA with all-cause mortality, cardiovascular mortality, and SCD using Cox proportional hazards models controlling for traditional CVD risk factors.

resultsSixty-six incident hemodialysis patients (12%) had OSA. Mean age (56 years) and percentage of males (56%) were identical in OSA and no-OSA groups. Fewer African Americans had OSA than non-African Americans (9 vs. 18%, respectively). Participants with OSA had higher body-mass index, Charlson comorbidity score, and left ventricular mass index and greater prevalence of diabetes and coronary artery disease. During 1,080 person-years of follow-up, 104 deaths occurred, 29% of which were cardiovascular. OSA was associated with a higher risk of all-cause mortality (HR 1.90 [95% CI 1.04-3.46]) and cardiovascular mortality (HR 3.62 [95% CI 1.36-9.66]) after adjusting for demographics and body-mass index. OSA was associated with a higher risk of SCD after adjusting for demographics (HR 3.28 [95% CI 1.12-9.57]) and multiple cardiovascular risk factors.

conclusionsIncident hemodialysis patients with OSA are at increased risk of all-cause and cardiovascular mortality and SCD. Future studies should assess the impact of screening for OSA and OSA-targeted interventions on mortality in ESRD.

Indexed as

AgedCause of DeathComorbidityCoronary DiseaseDeath, Sudden, CardiacFemaleFollow-Up StudiesHumansKaplan-Meier EstimateKidney Failure, ChronicMaleMiddle AgedPrevalenceProspective StudiesRenal DialysisSleep Apnea, ObstructiveCardiovascular deathCardiovascular diseaseHemodialysisObstructive sleep apneaSudden cardiac death

Identifiers

PMID30110675
PMCPMC6519703
OpenAlexW2886723220

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.