scholarly journals Risk of chronic kidney disease in patients with obstructive sleep apnea

SLEEP ◽  
2021 ◽  
Author(s):  
Andrew E Beaudin ◽  
Jill K Raneri ◽  
Sofia B Ahmed ◽  
A J Marcus Hirsch Allen ◽  
Andrhea Nocon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Kidney Disease ◽  
Ckd Progression ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Very High

Abstract Study Objectives Chronic kidney disease (CKD) is a global health concern and a major risk factor for cardiovascular morbidity and mortality. Obstructive sleep apnea (OSA) may exacerbate this risk by contributing to the development of CKD. This study investigated the prevalence and patient awareness of the risk of CKD progression in individuals with OSA. Methods Adults referred to five Canadian academic sleep centers for suspected OSA completed a questionnaire, a home sleep apnea test or in-lab polysomnography and provided blood and urine samples for measurement of estimated glomerular filtration rate (eGFR) and the albumin:creatinine ratio (ACR), respectively. The risk of CKD progression was estimated from a heat map incorporating both eGFR and ACR. Results 1295 adults (42% female, 54±13y) were categorized based on the oxygen desaturation index (4% desaturation): <15 (no/mild OSA, n=552), 15-30 (moderate OSA, n=322), and >30 (severe OSA, n=421). After stratification, 13.6% of the no/mild OSA group, 28.9% of the moderate OSA group, and 30.9% of the severe OSA group had a moderate-to-very high risk of CKD progression (p<0.001), which was defined as an eGFR < 60 mL/min/1.73m2, an ACR ≥3 mg/mmol, or both. Compared to those with no/mild OSA, the odds ratio for moderate-to-very high risk of CKD progression was 2.63 (95% CI: 1.79-3.85) for moderate OSA and 2.96 (2.04–4.30) for severe OSA after adjustment for CKD risk factors. Among patients at increased risk of CKD progression, 73% were unaware they had abnormal kidney function. Conclusion Patients with moderate and severe OSA have an increased risk of CKD progression independent of other CKD risk factors; most patients are unaware of this increased risk.

Abstract P186: Obstructive Sleep Apnea and Risk of Chronic Kidney Disease in the ARIC Sleep Heart Health Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Kelsie M Full ◽  
Chandra Jackson ◽  
Casey M Rebholz ◽  
Kunihiro Matsushita ◽  
Pamela L Lutsey
Keyword(s):  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Health Behaviors ◽  
Health Study ◽  
Apnea Hypopnea Index ◽  
Heart Health ◽  
Obstructive Sleep ◽  
Increased Risk

Background: Obstructive sleep apnea (OSA) is a prevalent sleep disorder and may be associated with the development of chronic kidney disease (CKD) through hypoxia, inflammation, and oxidative stress. However, the prospective relationship between OSA and incident CKD remains unknown. In this study, we leveraged in-home polysomnography (PSG) data from a large community-based cohort of adults to examine the association between OSA and risk of incident CKD in late-midlife. Methods: Participants in the Atherosclerosis Risk in Communities (ARIC) study (N=1,525; mean age=62.5 ± 5.4 years, 52.4% female) completed in-home PSG assessments as part of the Sleep Heart Health Study. OSA severity was defined according to apnea-hypopnea index (AHI) (events/hour): normal <5.0, mild 5.0-14.9, moderate 15.0-29.9, and severe ≥30.0. Incident CKD was defined according to estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 and at least 25% decline in eGFR from baseline, CKD-related hospitalization or death, or end-stage renal disease. Cox proportional hazards regression was used to estimate OSA severity with risk of incident CKD. Models were adjusted for demographics, health behaviors, BMI, and other markers of cardiometabolic conditions. Results: Among 1,525 participants, a total of 461 CKD events occurred over an average of 19 years of follow-up. After adjustment for demographics and health behaviors, severe OSA (AHI ≥30.0) was associated with increased risk of CKD (Hazard Ratio (HR): 1.51; 95% Confidence Interval (CI): 1.08, 2.10). This association was attenuated after additional adjustment for BMI (HR; 1.07, CI: 0.75, 1.52). Conclusions: Overall, OSA was linked to greater CKD risk. The association was attenuated after adjusting for obesity, a risk factor for both conditions. Due the high prevalence of OSA and CKD in the US adult population, more investigation is needed. Figure 1. Estimated probability of years free of Chronic Kidney Disease (CKD) by obstructive sleep apnea (OSA) severity in the ARIC Sleep Heart Health Study:

scholarly journals Risk for recurrent cardiovascular disease events among patients with diabetes and chronic kidney disease

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Demetria Hubbard ◽  
Lisandro D. Colantonio ◽  
Robert S. Rosenson ◽  
Todd M. Brown ◽  
Elizabeth A. Jackson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Health Insurance ◽  
High Risk ◽  
Kidney Disease ◽  
Peripheral Artery ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Very High

Abstract Background Adults who have experienced multiple cardiovascular disease (CVD) events have a very high risk for additional events. Diabetes and chronic kidney disease (CKD) are each associated with an increased risk for recurrent CVD events following a myocardial infarction (MI). Methods We compared the risk for recurrent CVD events among US adults with health insurance who were hospitalized for an MI between 2014 and 2017 and had (1) CVD prior to their MI but were free from diabetes or CKD (prior CVD), and those without CVD prior to their MI who had (2) diabetes only, (3) CKD only and (4) both diabetes and CKD. We followed patients from hospital discharge through December 31, 2018 for recurrent CVD events including coronary, stroke, and peripheral artery events. Results Among 162,730 patients, 55.2% had prior CVD, and 28.3%, 8.3%, and 8.2% had diabetes only, CKD only, and both diabetes and CKD, respectively. The rate for recurrent CVD events per 1000 person-years was 135 among patients with prior CVD and 110, 124 and 171 among those with diabetes only, CKD only and both diabetes and CKD, respectively. Compared to patients with prior CVD, the multivariable-adjusted hazard ratio for recurrent CVD events was 0.92 (95%CI 0.90–0.95), 0.89 (95%CI: 0.85–0.93), and 1.18 (95%CI: 1.14–1.22) among those with diabetes only, CKD only, and both diabetes and CKD, respectively. Conclusion Following MI, adults with both diabetes and CKD had a higher risk for recurrent CVD events compared to those with prior CVD without diabetes or CKD.

Prevalence of patients at risk for progression of chronic kidney disease in a sleep clinic cohort with obstructive sleep apnea

2019 ◽  
Vol 64 ◽  
pp. S28-S29
Author(s):  
A. Beaudin ◽  
R.P. Skomro ◽  
N.T. Ayas ◽  
J.K. Raneri ◽  
A. Nocon ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
At Risk ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Obstructive Sleep ◽  
Patients At Risk

scholarly journals Clinical Presentation of Obstructive Sleep Apnea in Patients with Chronic Kidney Disease

2012 ◽  
Vol 08 (04) ◽  
pp. 381-387 ◽  
Author(s):  
David D. M. Nicholl ◽  
Sofia B. Ahmed ◽  
Andrea H. S. Loewen ◽  
Brenda R. Hemmelgarn ◽  
Darlene Y. Sola ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Clinical Presentation ◽  
Obstructive Sleep

scholarly journals Risk of Obstructive Sleep Apnea and Its Association with Cardiovascular and Noncardiac Vascular Risk in Patients with Rheumatoid Arthritis: A Population-based Study

2017 ◽  
Vol 45 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Katelynn M. Wilton ◽  
Eric L. Matteson ◽  
Cynthia S. Crowson
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Medical Information ◽  
Statistical Significance ◽  
Vascular Events ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Large Joint

Objective.To define the incidence of obstructive sleep apnea (OSA) in patients with rheumatoid arthritis (RA) and determine whether OSA diagnosis predicts future cardiovascular disease (CVD) and noncardiac vascular events.Methods.Medical information pertaining to RA, OSA, CVD, and vascular diagnoses was extracted from a comprehensive medical record system for a geographically defined population of 813 patients previously diagnosed with RA and 813 age- and sex-matched comparator subjects.Results.The risk for OSA in persons with RA versus comparators was elevated, although not reaching statistical significance (HR 1.32, 95% CI 0.98–1.77; p = 0.07). Patients with RA were more likely to be diagnosed with OSA if they had traditional risk factors for OSA, including male sex, current smoking status, hypertension, diabetes, dyslipidemia, and increased body mass index. Features of RA disease associated with OSA included large joint swelling and joint surgery. Patients with RA with decreased renal function were also at higher risk of OSA. The increased risk of overall CVD among patients with RA who have OSA was similar to the increased CVD risk associated with OSA in the comparator cohort (interaction p = 0.86). OSA diagnosis was associated with an increased risk of both CVD (HR 1.9, 95% CI 1.08–3.27), and cerebrovascular disease (HR 2.4, 95% CI 1.14–5.26) in patients with RA.Conclusion.Patients with RA may be at increased risk of OSA secondary to both traditional and RA-related risk factors. Diagnosis with OSA predicts future CVD in RA and may provide an opportunity for CVD intervention.

scholarly journals Obstructive sleep apnea in non-dialysis chronic kidney disease patients

Renal Failure ◽  
2014 ◽  
Vol 37 (2) ◽  
pp. 214-218 ◽  
Author(s):  
G. Vijay Shanmugam ◽  
Georgi Abraham ◽  
Milly Mathew ◽  
V. Ilangovan ◽  
Madhusmita Mohapatra ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Obstructive Sleep

scholarly journals The Association of Sleep Disorders, Obesity and Sleep-Related Hypoxia with Cancer

2020 ◽  
Vol 21 (6) ◽  
pp. 444-453
Author(s):  
Anna Brzecka ◽  
Karolina Sarul ◽  
Tomasz Dyła ◽  
Marco Avila-Rodriguez ◽  
Ricardo Cabezas-Perez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Intermittent Hypoxia ◽  
Clock Genes ◽  
Cell Cancer ◽  
Cancer Risk Factors ◽  
Obstructive Sleep ◽  
Increased Risk

Background: Sleep disorders have emerged as potential cancer risk factors. Objective: This review discusses the relationships between sleep, obesity, and breathing disorders with concomitant risks of developing cancer. Results: Sleep disorders result in abnormal expression of clock genes, decreased immunity, and melatonin release disruption. Therefore, these disorders may contribute to cancer development. Moreover, in sleep breathing disorder, which is frequently experienced by obese persons, the sufferer experiences intermittent hypoxia that may stimulate cancer cell proliferation. Discussion: During short- or long- duration sleep, sleep-wake rhythm disruption may occur. Insomnia and obstructive sleep apnea increase cancer risks. In short sleepers, an increased risk of stomach cancer, esophageal squamous cell cancer, and breast cancer was observed. Among long sleepers (>9 hours), the risk of some hematologic malignancies is elevated. Conclusion: Several factors including insomnia, circadian disruption, obesity, and intermittent hypoxia in obstructive sleep apnea are contributing risk factors for increased risk of several types of cancers. However, further studies are needed to determine the more significant of these risk factors and their interactions.

scholarly journals Predictors of chronic kidney disease in obstructive sleep apnea patients

2020 ◽  
Vol 15 ◽  
Author(s):  
Phunphai Somkearti ◽  
Paiboon Chattakul ◽  
Sittichai Khamsai ◽  
Panita Limpawattana ◽  
Jarin Chindaprasirt ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
High Systolic Blood Pressure ◽  
Mallampati Score ◽  
Obstructive Sleep

Introduction: Obstructive sleep apnea (OSA) is a common condition in patients with chronic kidney disease (CKD). It may worsen renal function in CKD patients and is associated with uncontrolled blood pressure. Although OSA is found in up to 80% of CKD patients, there are limited data available on its clinical features in patients with and without CKD. Objective: This study aimed to identify the differences in the clinical characteristics of OSA between CKD and non-CKD OSA patients and determine the clinical predictors for CKD in OSA patients. Methods: This was a retrospective study conducted at Khon Kaen University's Srinagarind Hospital in Thailand between July and December 2018. The inclusion criteria were diagnosis with OSA via polysomnography and having undergone laboratory tests for CKD. Obstructive sleep apnea is diagnosed according to the apnea-hypopnea index (AHI) as experiencing >5 events/hour, while CKD diagnosed based on the KDOQI guidelines. Eligible patients were divided into two groups: OSA with CKD and OSA without CKD. Predictors of CKD in OSA patients were analyzed using multivariate logistic regression analysis. Results: During the study period, there were 178 OSA patients who met the study criteria, 88 (49.44%) of whom were in the OSA with CKD group. Both age and body mass index were comparable between OSA patients with CKD and those without (age: 59 and 57 years, respectively; body mass index: 30 and 29 kg/m2, respectively. There were three significant factors that differed between those with and without CKD group including systolic blood pressure (147 vs 135 mmHg), proportion of patients with diabetes (55% vs 34%), and proportion of patients with Mallampati scores of 3-4 (73% vs 39%). There were three independent predictors for OSA in patients with CKD: female sex, high systolic blood pressure, and Mallampati score of 3 or 4, with adjusted odds ratios (95% confidence interval) of 4.624 (1.554, 13.757), 1.060 (1.020, 1.101), and 2.816 (1.356, 5.849), respectively. The Hosmer-Lemeshow chi square statistic of the predictive model was 6.06 (p 0.640). Systolic blood pressure of more than 130 and 150 mmHg resulted in sensitivity of 84.21% and specificity of 81.40%, respectively. Conclusions: Female sex, high systolic blood pressure, and Mallampati score of 3-4 were suggestive of OSA with CKD. Obstructive sleep apnea patients with one or more of these predictors may have a high risk of CKD.

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