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Background: Sleep-disordered breathing (SDB) is highly prevalent in patients with advanced chronic kidney diseases (CKDs).Objective: To describe and compare the prevalence, severity, and patterns of SDB and associated nocturnal hypoxia among patients with advanced CKD, hemodialysis (HD) patients, and control group.Methods: Forty patients were recruited from outpatient nephrology clinics and hemodialysis units. Patients were stratified into two groups: conservative (n = 25), and HD (n = 15). 30 healthy individual enrolled as the control group. All participants completed polysomnography (PSG).Results: Case control study of forty CKD patients (15 HD and 25 conservative) [13(86.7%) and 20 (80%) men, mean age 62.73 ± 5.43 and 55.76 ± 9.03 year, BMI 40.83 ± 8.75 and 36.12 ± 16.53 kg/m, mean ESS 18.46 ± 3.20 and 17.84 ± 2.79), respectively, and 30 healthy participants served as the control. The prevalence of SDB in CKD was 33/40(82.5%). In the conservative group, AHI was 148.84 ± 147/h, [80% obstructive, 13% central, and 5% mixed apnea]. Among these conservative groups with OSA patients, 56% had severe, 31% moderate, and 12.5% mild OSA. While in the HD group, AHI 133.26 ± 111/h, [84.6% obstructive, 7.7% central, and 7.7% mixed apnea]. Among these HD groups with OSA, 63% had severe, 27% moderate, and 9% mild OSA. GFR was significantly correlated with AHI and ODI (r = À0.315, P < 0.05, r = À0.506, P < 0.001) respectively. AHI correlated with urea concentration (r = À0.094, P < 0.05). Increased creatinine, and decreased eGFR were significant risk factors of severe OSA. Predictors that reduced renal function were, decreased TST, delayed latency to REM sleep, and increased AHI.Conclusions: Severe OSA was highly prevalent among CKD. Urea was the stronger predictor of increased AHI.

Background: In real practice, Chronic Obstructive Pulmonary Diseases (COPD) is often diagnosed at a late stage as its clinical manifestations pass unnoticed and spirometry is almost not utilized. Objectives: To clarify the possibility of early detection of COPD by family physicians at the primary health care level. Methods: The study was conducted during the winter season (2015) in Al-Shohadaa family health center, Al-Shohadaa city, Menoufia governorate, Egypt. All patients ≥ 40 years, smoking ≥ 20 pack-years and attending the center with respiratory symptoms were subjected after their consent to a spirometry to check for early COPD diagnosis. Results: Although based on spirometry 33 out of 192 had COPD (18 (9.4%) had GOLD I and 15 (7.8%) had ≥ GOLD II, respectively), there was no significant difference in the type and the number of respiratory symptoms between Non-COPD and early COPD patients. Conclusion: It was demonstrated that the presenting symptoms specially in early stages could not discriminate the patients with COPD, so availability of spirometry in addition to training of family physicians at the family health care settings is a mandatory challenge for early diagnosis of COPD.