Obstructive sleep apnea and chronic kidney disease: open questions on a potential public health problem

Marrone, Oreste; Bonsignore, Maria R.

doi:10.21037/jtd.2017.12.12

Cited by 6 publications

(4 citation statements)

References 38 publications

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“…Obstructive sleep apnea (OSA) is a highly prevalent medical disorder among middle-age adults [1]. Accumulated data confirmed the bidirectional association between kidney diseases and OSA; for one thing, the incidence and mortality of OSA in kidney disease are higher than those in general population; for the other, OSA contributes the impairs of renal function [2, 3]. Our previous studies indicated that cystatin C, a biomarker of early renal impairs, was higher in several OSA patients without complications [4], and continuous positive airway pressure (CPAP) treatment can normalize cystatin C levels in those patients [5].…”

Section: Introductionmentioning

confidence: 99%

Telmisartan attenuates kidney apoptosis and autophagy-related protein expression levels in an intermittent hypoxia mouse model

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Telmisartan attenuates kidney apoptosis and autophagy-related protein expression levels in an intermittent hypoxia mouse model

et al. 2018

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“…Obesity is a major risk factor of OSAS [1,2,3,4,5,6,7], and both of these conditions impose adverse neurocognitive, mood, behavioral, cardiovascular, and metabolic consequences in both children and adults. In addition, as the awareness and consequently the frequency of diagnosing OSAS have increased, a large list of additional OSAS-associated morbidities has been reported, including chronic kidney disease, erectile dysfunction, ocular conditions, Alzheimer disease, nocturia, and even cancer in adults, while in children enuresis and bruxism are frequent adverse consequences [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31]. Efforts are ongoing to develop new and more effective therapies for OSAS based on underlying mechanisms promoting upper airway collapsibility during sleep [32,33].…”

Section: Obstructive Sleep Apnea Syndrome (Osas) and Morbiditymentioning

confidence: 99%

Obstructive Sleep Apnea and Inflammation: Proof of Concept Based on Two Illustrative Cytokines

Kheirandish‐Gozal

Gozal

2019

IJMS

233

156

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Obstructive sleep apnea syndrome (OSAS) is a markedly prevalent condition across the lifespan, particularly in overweight and obese individuals, which has been associated with an independent risk for neurocognitive, behavioral, and mood problems as well as cardiovascular and metabolic morbidities, ultimately fostering increases in overall mortality rates. In adult patients, excessive daytime sleepiness (EDS) is the most frequent symptom leading to clinical referral for evaluation and treatment, but classic EDS features are less likely to be reported in children, particularly among those with normal body-mass index. The cumulative evidence collected over the last two decades supports a conceptual framework, whereby sleep-disordered breathing in general and more particularly OSAS should be viewed as low-grade chronic inflammatory diseases. Accordingly, it is assumed that a proportion of the morbid phenotypic signature in OSAS is causally explained by underlying inflammatory processes inducing end-organ dysfunction. Here, the published links between OSAS and systemic inflammation will be critically reviewed, with special focus on the pro-inflammatory cytokines tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6), since these constitute classical prototypes of the large spectrum of inflammatory molecules that have been explored in OSAS patients.

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“…Many studies demonstrated that even mild impaired renal function, with transitory elevated level of serum creatinine, represents an important predictor for worsening of heart failure. The pathophysiology remains unclear, but venous congestion and intrabdominal pressure serve as a challenge for the development of new therapeutic approaches [35,36]. OSAS severity was correlated with elevated serum creatinine [37], while CKD stage 3 is considered a significant predictor of CSA, as was demonstrated by Fleischmann et al [38].…”

Section: Discussionmentioning

confidence: 99%

Particularities of Older Patients with Obstructive Sleep Apnea and Heart Failure with Mid-Range Ejection Fraction

Ardelean

Pescariu

et al. 2019

Medicina

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Background and objectives: Obstructive sleep apnea syndrome (OSAS) and heart failure (HF) are increasing in prevalence with a greater impact on the health system. The aim of this study was to assess the particularities of patients with OSAS and HF, focusing on the new class of HF with mid-range ejection fraction (HFmrEF, EF = 40%–49%), and comparing it with reduced EF (HFrEF, EF < 40%) and preserved EF (HFpEF, EF ≥ 50%). Materials and Methods: A total of 143 patients with OSAS and HF were evaluated in three sleep labs of “Victor Babes” Hospital and Cardiovascular Institute, Timisoara, Western Romania. We collected socio-demographic data, anthropometric sleep-related measurements, symptoms through sleep questionnaires and comorbidity-related data. We performed blood tests, cardio-respiratory polygraphy and echocardiographic measurements. Patients were divided into three groups depending on ejection fraction. Results: Patients with HFmrEF were older (p = 0.0358), with higher values of the highest systolic blood pressure (mmHg) (p = 0.0016), higher serum creatinine (p = 0.0013), a lower glomerular filtration rate (p = 0.0003), higher glycemic levels (p = 0.008) and a larger left atrial diameter (p = 0.0002). Regarding comorbidities, data were presented as percentage, HFrEF vs. HFmrEF vs. HFpEF. Higher prevalence of diabetes mellitus (52.9 vs. 72.7 vs. 40.2, p = 0.006), chronic kidney disease (17.6 vs. 57.6 vs. 21.5, p < 0.001), tricuspid insufficiency (76.5 vs. 84.8 vs.59.1, p = 0.018) and aortic insufficiency (35.3 vs.42.4 vs. 20.4, p = 0.038) were observed in patients with HFmrEF, whereas chronic obstructive pulmonary disease(COPD) (52.9 vs. 24.2 vs.18.3, p = 0.009), coronary artery disease(CAD) (82.4 vs. 6.7 vs. 49.5, p = 0.026), myocardial infarction (35.3 vs. 24.2 vs. 5.4, p < 0.001) and impaired parietal heart kinetics (70.6 vs. 68.8 vs. 15.2, p < 0.001) were more prevalent in patients with HFrEF. Conclusions: Patients with OSAS and HF with mid-range EF may represent a new group with increased risk of developing life-long chronic kidney disease, diabetes mellitus, tricuspid and aortic insufficiency. COPD, myocardial infarction, impaired parietal kinetics and CAD are most prevalent comorbidities in HFrEF patients but they are closer in prevalence to HFmrEF than HFpEF.

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Obstructive sleep apnea and chronic kidney disease: open questions on a potential public health problem

Cited by 6 publications

References 38 publications

Telmisartan attenuates kidney apoptosis and autophagy-related protein expression levels in an intermittent hypoxia mouse model

Telmisartan attenuates kidney apoptosis and autophagy-related protein expression levels in an intermittent hypoxia mouse model

Obstructive Sleep Apnea and Inflammation: Proof of Concept Based on Two Illustrative Cytokines

Particularities of Older Patients with Obstructive Sleep Apnea and Heart Failure with Mid-Range Ejection Fraction

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