Obstructive sleep apnea syndrome is related to the progression of chronic kidney disease

Kanbay, Asiye; Büyükoğlan, Hakan; Ozdogan, Nezihe; Kaya, Elif; Oymak, Fatma Sema; Gülmez, İnci; Demir, Ramazan; Köktürk, Oğuz; Covic, Adrian

doi:10.1007/s11255-011-9927-8

Cited by 63 publications

(37 citation statements)

References 18 publications

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“…Recently, one study revealed that PSG variable, AHI and oxygen desaturation index, are independently associated with renal functional decline [9]. Data from Kanbay et al [28] also indicated that a significant decrease of GFR was detected in severe OSA patients, and they speculate that OSA is an independent risk factor of the progression of CKD.…”

Section: Discussionmentioning

confidence: 99%

Effect of continuous positive airway pressure on serum cystatin C among obstructive sleep apnea syndrome patients

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Effect of continuous positive airway pressure on serum cystatin C among obstructive sleep apnea syndrome patients

et al. 2014

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“…Cross-sectional cohort studies have demonstrated a significant direct association between the severity of sleep apnea and the severity of renal dysfunction. [270][271][272][273][274][275][276] In addition, cohort studies of the longitudinal relationship between sleep apnea and kidney function show that apnea is independently associated with an increased risk of accelerated loss of kidney function. 277,278 Conversely, as kidney function declines, the prevalence of sleep apnea and nocturnal hypoxia increases.…”

Section: Repeated Episodes Of Acute Kidney Injurymentioning

confidence: 99%

Hypoxia: The Force that Drives Chronic Kidney Disease

Colgan

Shelley

2016

Clinical Medicine & Research

125

111

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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.

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“…We and others have performed crosssectional studies showing a significant negative association between the prevalence and/or severity of SDB and kidney function in the CKD population (1)(2)(3)(4)26). To date, there is only a single cohort study of the longitudinal relationship between SDB and kidney function, which showed that NH was a significant predictor of accelerated loss of kidney function (27).…”

Section: Introductionmentioning

confidence: 99%

Association of Nocturnal Hypoxemia with Progression of CKD

Sakaguchi¹,

Hatta

Hayashi

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Nocturnal hypoxemia is highly prevalent among patients with CKD. Nocturnal hypoxemia contributes to systemic inflammation, oxidative stress, endothelial cell dysfunction, and activation of the renin-angiotensin system, which are common pathologic mechanisms of CKD progression. This study investigated whether nocturnal hypoxemia is independently associated with CKD progression.Design, setting, participants, & measurements This two-center retrospective cohort study included 161 patients with stages 3-4 CKD enrolled from January of 2009 to July of 2011 with a body mass index less than 25.0 kg/m 2 . The 4% oxygen desaturation index, the number of events per hour in which oxygen saturation decreases by .4% during sleep, was measured, and the declining rate of the estimated GFR was followed over 1 year. The severity of nocturnal hypoxemia was categorized as none (oxygen desaturation index,5.0), mild (5.0#oxygen desaturation index,15.0), or moderate to severe (15.0#oxygen desaturation index).Results The mean estimated GFR of the total cohort at baseline was 31 ml/min per 1.73 m 2 . Eighty patients (49.7%) were diagnosed with nocturnal hypoxemia; 64 patients were diagnosed with mild nocturnal hypoxemia, and 16 patients were diagnosed with moderate-to-severe nocturnal hypoxemia. The estimated GFR declined three-to fourfold faster in patients with moderate-to-severe nocturnal hypoxemia than patients with no or mild nocturnal hypoxemia ( per year in the no, mild, and moderate-to-severe nocturnal hypoxemia groups, respectively; P=0.003). Nocturnal hypoxemia remained a significant predictor of decline in estimated GFR after adjustment for various baseline clinical factors.Conclusions In nonobese patients with CKD, nocturnal hypoxemia is an independent risk factor of a rapid decline in kidney function.

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Obstructive sleep apnea syndrome is related to the progression of chronic kidney disease

Abstract: In the light of the present study, we speculate that OSAS is an independent risk factor for the progression of chronic kidney disease, which is a growing health problem. Further randomized-multicenter prospective studies are warranted to evaluate this relationship.

Cited by 63 publications

References 18 publications

Effect of continuous positive airway pressure on serum cystatin C among obstructive sleep apnea syndrome patients

Effect of continuous positive airway pressure on serum cystatin C among obstructive sleep apnea syndrome patients

Hypoxia: The Force that Drives Chronic Kidney Disease

Association of Nocturnal Hypoxemia with Progression of CKD

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