Evidence map›Paper›PMID 39676147›Full record

ArticleClinical and experimental nephrology2025

Survival benefit of CPAP therapy among dialysis patients with obstructive sleep apnea.

Kunitoshi Iseki, Takuhiro Moromizato, Chiho Iseki, Kei Nakamura, Hiroshi Nakamura

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Article in Clinical and experimental nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

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3citing papers in PubMed, 1 pooled it
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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.

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Kunitoshi IsekiNakamura Clinic, Urasoe, Okinawa, Japan. chihokun_ohra@yahoo.co.jp.ORCID http://orcid.org/0000-0001-6624-0216
Takuhiro MoromizatoRenal and Rheumatology Division, Internal Medicine Department, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Okinawa, Japan.
Chiho IsekiNakamura Clinic, Urasoe, Okinawa, Japan.
Kei NakamuraNakamura Clinic, Urasoe, Okinawa, Japan.
Hiroshi NakamuraNakamura Clinic, Urasoe, Okinawa, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and hypothesisWe observed lower risk of all-cause mortally among continuous positive airway pressure (CPAP) users compared to those non-users using a large polysomnography (PSG) registry. However, the effect of CPAP on mortality risk has not been examined in dialysis patents.

methodsWe studied 9841 patients with PSG performed from September 1990 to 2010 in Nakamura clinic, Okinawa. Among them, we found 195 dialysis patients: 16 (1.0%) dialysis patients with apnea hypopnea index (AHI) < 5/hour in 1665 subjects and 179 (2.2%) in 8176 obstructive sleep apnea (OSA) patients. CPAP users were defined as patients who had been on CPAP for more than one month. Patients qualified and eligible for CPAP but refused were assigned as CPAP non-users. The median observation was 6.6 years. Mortality rates were compared between CPAP users and non-users using multivariate logistic analysis adjusted for age, sex, body mass index (BMI), AHI and medical history.

resultsAmong OSA dialysis patients (men 127, women 37), 116 (2.6%) were CPAP users and 48 (2.3%) were CPAP non-users. The number of deaths was 52 (29 CPAP users and 23 (CPAP non-users) during follow-up. The death rate was 25.0% for CPAP users and 47.9% for non-users. CPAP users showed better survival; hazard ratio (HR) 0.47 and 95% confidence interval (CI) of 0.27-0.81 (P = 0.007).

conclusionDialysis patients with OSA showed better survival rates with the use of CPAP. Screening for OSA is recommended if patients complain of sleep problems, such as insomnia, daytime sleepiness, headache, and fatigue.

Indexed as

Continuous Positive Airway PressureRenal DialysisSleep Apnea, ObstructiveAdultAgedFemaleHumansJapanLogistic ModelsMaleMiddle AgedMultivariate AnalysisPolysomnographyRisk FactorsTime FactorsTreatment OutcomeCPAPDialysis patientsOSASurvival

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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.