Association of Obstructive Sleep Apnea With Urinary Albumin Excretion in Essential Hypertension: A Cross-sectional Study

Tsioufis, Costas; Thomopoulos, Costas; Dimitriadis, Kyriakos; Amfilochiou, Anastasia; Tsiachris, Dimitris; Selima, Maria; Petras, Dimitris; Kallikazaros, Ioannis; Stefanadis, Christodoulos

doi:10.1053/j.ajkd.2008.05.001

Cited by 68 publications

(55 citation statements)

References 38 publications

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“…76 A cross-sectional study compared albuminuria levels in hypertensive patients with and without OSA. 91 All recruited subjects had untreated hypertension (stage I or II). Urinary albumin excretion was significantly higher in the OSA-hypertensive group (by 57%), suggesting a pathophysiological linkage between OSA and dysfunctional kidney vasculature, particularly in hypertensive patients.…”

Section: Hypertensionmentioning

confidence: 99%

Obstructive Sleep Apnea and Kidney Disease: A Potential Bidirectional Relationship?

Abuyassin

Sharma

Ayas

et al. 2015

Journal of Clinical Sleep Medicine

108

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Section: Hypertensionmentioning

confidence: 99%

Obstructive Sleep Apnea and Kidney Disease: A Potential Bidirectional Relationship?

Abuyassin

Sharma

Ayas

et al. 2015

Journal of Clinical Sleep Medicine

108

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“…Many studies have shown that urinary albumin-creatinine ratio is an independent risk factor associated with the severity of OSA [54][55][56] . Faulx et al [54] have shown that the severity of OSA is significantly associated with increased urine albumin excretion.…”

Section: Osa and Proteinuriamentioning

confidence: 99%

The Triad of Sleep Apnea, Hypertension, and Chronic Kidney Disease: A Spectrum of Common Pathology

2016

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Obstructive sleep apnea (OSA), hypertension, and chronic kidney disease (CKD) are different entities and are generally managed individually most of the time. However, CKD, OSA, and hypertension share many common risk factors and it is not uncommon to see this complex triad together. In fact, they share similar pathophysiology and have been interlinked with each other. The common pathophysiology includes chronic volume overload, hyperaldosteronism, increased sympathetic activity, endothelial dysfunction, and increased inflammatory markers. The combination of this triad has significant negative impact on the cardiovascular health, and increases the mortality and morbidity in this complicated group of patients. On one hand, progression of CKD can lead to the worsening of OSA and hypertension; similarly, worsening sleep apnea can make the hypertension difficult to treat and enhance the progression of CKD. This review article highlights the bidirectional interlink among these apparently different disease processes which share common pathophysiological mechanisms and emphasizes the importance of treating them collectively to improve outcomes.

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“…A cross-sectional study showed nondiabetic adults with untreated hypertension to have significantly greater ACR (by 57%) in the presence of OSA that correlated with AHI and 24-hour pulse pressure [20]. A case-control study showed low-grade albuminuria in nondiabetic normotensive adults with OSA that correlated with length of time at oxygen saturation <90% and BMI [21].…”

Section: Discussionmentioning

confidence: 99%

Albuminuria and Renal Function in Obese Adults Evaluated for Obstructive Sleep Apnea

et al. 2009

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Background: Obstructive sleep apnea (OSA) is associated with hypertension, obesity and metabolic syndrome that are risk factors for cardiovascular and chronic kidney disease. Few data are available regarding renal parameters in patients with OSA. Methods: We conducted a cross-sectional study of 91 obese adults who had routine polysomnography before bariatric surgery. Presence and severity of OSA were determined by the apnea-hypopnea index (AHI <5 = no OSA and AHI ≥5 = OSA). Clinical and laboratory data were available within a month of polysomnography. Results: Mean ± SD age was 44.9 ± 9.9 years. There were 66 women. Mean ± SD body mass index was 48.3 ± 8.9 kg/m² with hypertension and type 2 diabetes present in 55 and 31 subjects, respectively. There were 36 subjects with no OSA and 55 with OSA. The two groups had similar demographic characteristics, blood pressure (BP), lipid profile and medication use except for difference in mean ± SD hemoglobin A1c (5.6 ± 0.6% in no OSA, 6.0 ± 0.8% in OSA; p = 0.029) and use of renin-angiotensin system blocking agents (22.2% in no OSA, 46.4% in OSA; p = 0.024). Median (interquartile range) urine albumin:creatinine ratio (ACR) was not different between the two groups [6 (4–14.5) mg/g in no OSA, 8 (5–16) mg/g in OSA; p = 0.723], while significant difference existed in serum creatinine (0.8 ± 0.2 mg/dl in no OSA, 0.9 ± 0.2 mg/dl in OSA, p = 0.013). Age- and gender-adjusted correlations were observed between log-log ACR and systolic BP (r = 0.265; p = 0.016), log-log ACR and diastolic BP (r = 0.245; p = 0.026) and between serum creatinine and log AHI (r = 0.188, p = 0.089). Multiple linear regression analysis demonstrated log-log ACR to be associated with diastolic BP (p = 0.046), while serum creatinine was associated with log AHI (p = 0.044). Conclusion: In obese adults, increasing severity of OSA is associated with higher serum creatinine but not greater degree of albuminuria.

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Association of Obstructive Sleep Apnea With Urinary Albumin Excretion in Essential Hypertension: A Cross-sectional Study

Cited by 68 publications

References 38 publications

Obstructive Sleep Apnea and Kidney Disease: A Potential Bidirectional Relationship?

Obstructive Sleep Apnea and Kidney Disease: A Potential Bidirectional Relationship?

The Triad of Sleep Apnea, Hypertension, and Chronic Kidney Disease: A Spectrum of Common Pathology

Albuminuria and Renal Function in Obese Adults Evaluated for Obstructive Sleep Apnea

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