Chronic Kidney Disease and Sleeping Disordered Breathing (SDB)

Santos, Roberto Sávio Silva; Motwani, Shveta S.; Elias, Rosilene Motta

doi:10.2174/1573402112666160114094222

Cited by 6 publications

(2 citation statements)

References 65 publications

(63 reference statements)

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“…In summary, patients with kidney disease, particularly those on dialysis, and patients with nephrotic syndrome are more prone to have SA. The role of fluid overload and overnight fluid shift as risk factors for SA were well demonstrated in these settings ( 14 , 15 , 54 , 60 , 62 – 66 ). The data presented in these cited studies suggest that kidney disease and nephrotic syndrome might cause SA independently of confounding factors.…”

Section: Sa In Kidney Diseasementioning

confidence: 91%

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Fluid Redistribution in Sleep Apnea: Therapeutic Implications in Edematous States

et al. 2018

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Sleep apnea (SA), a condition associated with increased cardiovascular risk, has been traditionally associated with obesity and aging. However, in patients with fluid-retaining states, such as congestive heart failure and end-stage renal disease, both prevalence and severity of SA are increased. Recently, fluid shift has been recognized to play an important role in the pathophysiology of SA, since the fluid retained in the legs during the day shifts rostrally while recumbent, leading to edema of upper airways. Such simple physics, observed even in healthy individuals, has great impact in patients with fluid overload. Correction of the excess fluid volume has risen as a potential target therapy to improve SA, by attenuation of nocturnal fluid shift. Such strategy has gained special attention, since the standard treatment for SA, the positive airway pressure, has low compliance rates among its users and has failed to reduce cardiovascular outcomes. This review focuses on the pathophysiology of edema and fluid shift, and summarizes the most relevant findings of studies that investigated the impact of treating volume overload on SA. We aim to expand horizons in the treatment of SA by calling attention to a potentially reversible condition, which is commonly underestimated in clinical practice.

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Section: Sa In Kidney Diseasementioning

confidence: 91%

“…Sleep apnea can exert a high impact on CKD mortality ( 52 ), given is very high prevalence (up to 80%) among these patients ( 14 , 53 , 54 ), and its well-known association with cardiovascular events ( 8 , 55 , 56 ). Therefore, recognizing SA in this population is imperative.…”

Section: Sa In Kidney Diseasementioning

confidence: 99%