The association of kidney function with repetitive breath-hold diving activities of female divers from Korea, Haenyeo

• Published in: BMC nephrology Vol. 18; no. 1; p. 75
• Main Authors: Oh, Yun Jung, Jung, Ji Yong, Kim, Sung Soo, Chae, Kyong-Suk, Rhu, Jiwon, Lee, Chungsik
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23.02.2017; BioMed Central
• Subjects: Adult; Apnea; Breath Holding; Cardiovascular diseases; Case-Control Studies; Cross-Sectional Studies; Diving - statistics & numerical data; Female; Glomerular Filtration Rate; Health aspects; Humans; Middle Aged; Motor vehicle driving; Multivariate Analysis; Nephrology; Odds Ratio; Physiological aspects; Propensity Score; Renal Insufficiency, Chronic - epidemiology; Republic of Korea - epidemiology; Risk factors; South Korea; Breath-hold diving; Kidney function; Repetitive apnea
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-017-0481-1

Voluntary apnea during breath-hold diving (BHD) induces cardiovascular changes including bradycardia, reduced cardiac output, and arterial hypertension. Although the impacts of repetitive BHD on cardiovascular health have been studied previously, the long-term risk for kidney dysfunction has never been investigated. A cross-sectional propensity score-matched study was performed to evaluate the influence of repetitive long-lasting BHD on kidney function. Using matching propensity scores (PS), 715 breath-hold female divers (Haenyeo) and non-divers were selected for analysis from 1,938 female divers and 3,415 non-divers, respectively. The prevalence of chronic kidney disease (CKD) defined as an estimated glomerular filtration rate (eGFR) calculated to be less than 60 ml/min/1.73 m was investigated in both diver and non-diver groups. The prevalence of CKD was significantly higher in breath-hold divers compared with non-divers after PS matching (12.6% vs. 8.0%, P = 0.004). In multivariate analysis, BHD activity was significantly associated with the risk of CKD in an unmatched cohort (OR, 1.976; 95% CI, 1.465-2.664). In the PS-matched cohort, BHD remained the independent risk factor for CKD even after adjusting for multiple covariates (OR 1.967; 95% CI, 1.341-2.886). Shallow but repetitive intermittent apnea by BHD, sustained for a long period of time, may potentially cause a deterioration in kidney function, as a long-term consequence.