**1. Introduction**

384 Chronic Kidney Disease

*E. coli* bacteriuria is not associated with a decline in renal function or the development of end-stage renal failure in a population of generally healthy adult women. However, *E. coli* bacteriuria may increase the risk of future hypertension, but the pathogenesis is not

Women with DM (type 1 or type 2) with ASB do not have an increased risk for a faster decline in renal function or the development of hypertension. Therefore, screening and

Since nearly all studies are performed in women, it is not possible to make conclusions

No differences in renal function prognosis between patients with and without ASB following kidney transplantation were demonstrated. However, the incidence of pyelonephritis was much higher in the group of patients with ASB. Therefore, screening

Lindberg U, Claesson I, Hanson LA, Jodal U. Asymptomatic bacteriuria in schoolgirls. VIII. Clinical course during a 3-year follow-up. J Pediatr. 1978 Feb;92(2):194-9. Meiland R, Stolk RP, Geerlings SE, Peeters PH, Grobbee DE, Coenjaerts FE, Brouwer EC,

in women: long-term follow-up. Arch Intern Med. 2007 Feb 12;167(3):253-7. R Meiland, SE Geerlings, RP Stolk,.IM. Hoepelman, PHM Peeters, FEJ Coenjaerts, DE Grobbee.

Tencer J. Asymptomatic bacteriuria--a long-term study. Scand J Urol Nephrol. 1988;22(1):31-4. Meiland R, Geerlings SE, Stolk RP, Netten PM, Schneeberger PM, Hoepelman AIM.

Semetkowska-Jurkiewicz E, Horoszek-Maziarz S, Galiński J, Manitius A, Krupa-

diabetic patients--14-year follow-up. Mater Med Pol. 1995 Jul-Sep;27(3):91-5. Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Infectious Diseases

Harding GK, Zhanel GG, Nicolle LE, Cheang M; Manitoba Diabetes Urinary Tract Infection

Dalal S, Nicolle L, Marrs CF, Zhang L, Harding G, Foxman B. Long-term *Escherichia coli*

Fiorante S, López-Medrano F, Lizasoain M, Lalueza A, Juan RS, Andrés A, Otero JR,

bacteriuria in adults. Clin Infect Dis. 2005;40(5):643-54.

bacteriuria. N Engl J Med. 2002 Nov 14;347(20):1576-83.

Hoepelman AI. Association between *Escherichia coli* bacteriuria and renal function

*Escherichia coli* bacteriuria in female adults is associated with the development of hypertension. International Journal of Infectious Diseases. 2010 April 14(4): e304-307.

Asymptomatic bacteriuria in women with diabetes mellitus. Arch Intern Med

Wojciechowska B. The clinical course of untreated asymptomatic bacteriuria in

Society of America guidelines for the diagnosis and treatment of asymptomatic

Study Group. Antimicrobial treatment in diabetic women with asymptomatic

asymptomatic bacteriuria among women with diabetes mellitus. Clin Infect Dis.

Morales JM, Aguado JM. Systematic screening and treatment of asymptomatic bacteriuria in renal transplant recipients. Kidney Int. 2010 Oct;78(8):774-81. Epub

about the association between ASB, renal function and hypertension in men.

treatment of ASB in diabetic women is not warranted.

protocols may be beneficial in this group of patients.

**6. Conclusions** 

understood.

**7. References** 

2006;166:2222-7.

2009 Aug 15;49(4):491-7.

2010 Aug 18.

Twenty-six million American adults have Chronic Kidney Disease (CKD). Chronic Kidney Disease is defined as kidney damage for 3 or more months with or without decreased GFR. Chronic Kidney Disease is divided into five stages, from Stage 1 to Stage 5. End-Stage renal disease is the 5th stage of CKD when dialysis is needed to sustain life. Sleep disorders are common and under recognized in advanced stages of Chronic Kidney Disease. Sleep disorders affect the quality of life and may also increase cardiovascular morbidity and mortality.

Subjective sleep complaints are reported by more than 50% of patients on Hemodialysis (HD) (1). Common organic sleep disorders in patients with CKD include Sleep Apnea Syndrome (SAS), Periodic Limb Movement Disorder (PLMD) and Restless Leg Syndrome (RLS). These disorders are more common in the dialysis population than in the general population. When dialysis patients with a sleep disorders were studied objectively in sleep laboratory, 53% to 75% were found to have sleep apnea, which is higher than general population (2-4%) (2). Sleep disorders in CKD patients have been linked to increased incidences of cardiovascular disease including coronary artery disease, left ventricular hypertrophy and hypertension. (3, 4, 5, 6). Heart disease is the major cause of death in patients with CKD (www.kidney.org). In fact most patients who have advanced CKD and are not on dialysis are more likely to die from heart disease before they start dialysis.

Daytime somnolence resulting from sleep disorders may lead to diminished quality of life and cognition (7, 8).PLMD is associated with increased mortality in patients with ESRD. (49). Early diagnosis and treatment may improve quality of life.
