Effect of continuous positive airway pressure on proteinuria in obstructive sleep apnea

Masuda, Tomoyuki; Honma, Sato; Sasaki, Nobuhiro; Hanawa-Yazawa, Shiho; Iwazu, Yoshitaka; Kusano, Eiji; Asano, Yoshihide

doi:10.1093/ckj/sfs046

Cited by 5 publications

(2 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have mounting evidences of OSA accelerating diabetes nephropathy [ 19 , 27 ], and a small study and case report showed that CPAP treatment may improve proteinuria in diabetes patients [ 28 , 29 ]. There are many factors including sleep cycle and the renin-angiotensin-aldosterone system [ 30 , 31 ], intermittent hypoxia-induced endothelial dysfunction and artery stiffness [ 32 – 34 ], and renal tubular dysfunction-related nocturnal natriuresis [ 29 , 35 , 36 ] that may impact kidney function from OSA.…”

Section: Discussionmentioning

confidence: 99%

Simple obstructive sleep apnea patients without hypertension or diabetes accelerate kidney dysfunction: a population follow-up cohort study from Taiwan

Lin

Liu

Lin³

et al. 2016

Sleep Breath

View full text Add to dashboard Cite

BackgroundsObstructive sleep apnea (OSA) is common in patients on hemodialysis, but its correlation with chronic kidney disease (CKD) is not clear. We aimed to clarify the relationship between OSA without hypertension or diabetes and incidence of CKD in Taiwan.MethodsThis population-based cohort study consisted of patients with newly diagnosed OSA between 2000 and 2009. The comparison cohort was matched for age, sex, diabetes mellitus, and hypertension. All subjects previously diagnosed with acute or chronic kidney disease were excluded. The primary end point was newly diagnosed CKD.ResultsWe identified 6866 subjects with OSA during the 10-year study period. The median duration until development of CKD in the OSA cohort was 3.2 years, 2.5 months earlier than that in the non-OSA cohort. After exclusion of hypertension and diabetes, 4319 OSA patients was identified and the hazard ratio (HR) of CKD with OSA was 1.37 (95 % confidence interval [CI], 1.05–1.77; p = 0.019). In the subgroup analysis, an increased incidence of CKD in OSA was observed in women (HR, 1.41; 95 % CI, 1.12–1.78; p = 0.0036).ConclusionsThis longitudinal population-based cohort study provides evidence that patients with OSA even without diabetes or hypertension are at higher risk of developing CKD over the next 3 years and nearly 2.5 months earlier than the non-OSA cohort, particularly women.

show abstract

Section: Discussionmentioning

confidence: 99%

Simple obstructive sleep apnea patients without hypertension or diabetes accelerate kidney dysfunction: a population follow-up cohort study from Taiwan

Lin

Liu

Lin³

et al. 2016

Sleep Breath

View full text Add to dashboard Cite

show abstract

“…Systemic oxygenation strategies include the administration of erythropoietin to increase hematocrit levels, apparatus to effect continuous positive airway pressure, and whole-body chambers to produce an environment of 100% oxygen. 81,83,87,[110][111][112]377,378 Artery narrowing is already routinely counteracted by renal angioplasty with or without stenting and the administration of vasoconstriction inhibitors that target the renin-angiotensin-aldosterone system. 49,[379][380][381] The targeting of vasoconstriction pathways controlled through vasopressin, endothelin, and voltage dependent calcium channels are in their infancy, as is the use of vasodilators such as arginine and kallikrein.…”

Section: A New Hypoxia Paradigmmentioning

confidence: 99%

Hypoxia: The Force that Drives Chronic Kidney Disease

Colgan

Shelley

2016

Clinical Medicine & Research

125

111

View full text Add to dashboard Cite

In the United States the prevalence of end-stage renal disease (ESRD) reached epidemic proportions in 2012 with over 600,000 patients being treated. The rates of ESRD among the elderly are disproportionally high. Consequently, as life expectancy increases and the baby-boom generation reaches retirement age, the already heavy burden imposed by ESRD on the US health care system is set to increase dramatically. ESRD represents the terminal stage of chronic kidney disease (CKD). A large body of evidence indicating that CKD is driven by renal tissue hypoxia has led to the development of therapeutic strategies that increase kidney oxygenation and the contention that chronic hypoxia is the final common pathway to end-stage renal failure. Numerous studies have demonstrated that one of the most potent means by which hypoxic conditions within the kidney produce CKD is by inducing a sustained inflammatory attack by infiltrating leukocytes. Indispensable to this attack is the acquisition by leukocytes of an adhesive phenotype. It was thought that this process resulted exclusively from leukocytes responding to cytokines released from ischemic renal endothelium. However, recently it has been demonstrated that leukocytes also become activated independent of the hypoxic response of endothelial cells. It was found that this endothelium-independent mechanism involves leukocytes directly sensing hypoxia and responding by transcriptional induction of the genes that encode the β2-integrin family of adhesion molecules. This induction likely maintains the long-term inflammation by which hypoxia drives the pathogenesis of CKD. Consequently, targeting these transcriptional mechanisms would appear to represent a promising new therapeutic strategy.

show abstract

Reversibility of microalbuminuria with continuous positive airway pressure treatment in obstructive sleep apnea syndrome

Parmaksız

2020

Int Urol Nephrol

View full text Add to dashboard Cite

Effect of continuous positive airway pressure on proteinuria in obstructive sleep apnea

Cited by 5 publications

References 32 publications

Simple obstructive sleep apnea patients without hypertension or diabetes accelerate kidney dysfunction: a population follow-up cohort study from Taiwan

Simple obstructive sleep apnea patients without hypertension or diabetes accelerate kidney dysfunction: a population follow-up cohort study from Taiwan

Hypoxia: The Force that Drives Chronic Kidney Disease

Reversibility of microalbuminuria with continuous positive airway pressure treatment in obstructive sleep apnea syndrome

Contact Info

Product

Resources

About