Abstract 15816: Contemporary Nationwide Trends in Major Adverse Cardiovascular and Cerebrovascular Events Among Elderly Chronic Kidney Disease Patients With versus Without Obstructive Sleep Apnea and Associated Sex and Racial Disparities, 2016-2019

Background: End-stage renal disease (ESRD) patients with more intensive renal replacement therapy have been shown to alleviate the severity of sleep apnea, specifically obstructive sleep apnea (OSA). Our study aims to analyze the trends in combined cardiovascular events among geriatric CKD patients, comparing those with and without OSA. Methods: We conducted a comprehensive analysis using nationwide data from 2016 to 2019 to identify geriatric CKD patients based on ICD-10 codes. A comparative assessment was performed between elderly CKD patients with and without OSA, examining their baseline characteristics and potential disparities related to sex and race. Results: From 2016 to 2019, 14,157,877 geriatric CKD patients were analyzed. OSA is more prevalent in men (60.5% v/s 50.5%) and in the white race(79.3% v/s 72.5%) compared to the non-OSA group. In the OSA group, men had an increased prevalence of major adverse cardiovascular and cerebrovascular events (MACCE) (12.0% v/s 9.7%) and acute myocardial infarction (AMI)(7.0%-5.2%) with p<0.001. OSA patients had a decrease in all-cause mortality (3.2% v/s 4.7%), AMI (6.3% v/s 7.2%), and cardiac arrest (1.0% v/s 1.3%), with p<0.001. Patient’s on BiPAP/CPAP therapy have further decreased ODD’s of MACCE and is statistically significant, p<0.001. Conclusion: OSA patients with or without BiPAP/CPAP are associated with decreased MACCE in elderly CKD patients. The potential impact of Interventions like BiPAP/CPAP therapy on kidney function and cardiovascular outcomes requires further investigation to better understand and manage chronic kidney disease and OSA cardiovascular paradox.