scholarly journals The Triad of Sleep Apnea, Hypertension, and Chronic Kidney Disease: A Spectrum of Common Pathology

2016 ◽  
Vol 7 (1) ◽  
pp. 74-82 ◽  
Author(s):  
Fahad Aziz ◽  
Kunal Chaudhary
Keyword(s):  
Chronic Kidney Disease ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Cardiovascular Health ◽  
Negative Impact ◽  
Volume Overload ◽  
Mortality And Morbidity ◽  
Obstructive Sleep ◽  
Significant Negative Impact ◽  
Common Risk Factors

Obstructive sleep apnea (OSA), hypertension, and chronic kidney disease (CKD) are different entities and are generally managed individually most of the time. However, CKD, OSA, and hypertension share many common risk factors and it is not uncommon to see this complex triad together. In fact, they share similar pathophysiology and have been interlinked with each other. The common pathophysiology includes chronic volume overload, hyperaldosteronism, increased sympathetic activity, endothelial dysfunction, and increased inflammatory markers. The combination of this triad has significant negative impact on the cardiovascular health, and increases the mortality and morbidity in this complicated group of patients. On one hand, progression of CKD can lead to the worsening of OSA and hypertension; similarly, worsening sleep apnea can make the hypertension difficult to treat and enhance the progression of CKD. This review article highlights the bidirectional interlink among these apparently different disease processes which share common pathophysiological mechanisms and emphasizes the importance of treating them collectively to improve outcomes.

Risk Factors for Chronic Kidney Disease

2019 ◽  
pp. 29-38
Author(s):  
Hania Kassem ◽  
Bernard G. Jaar
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Stones ◽  
Developed Countries ◽  
Modifiable Risk Factors ◽  
Public Health Burden ◽  
Obstructive Sleep ◽  
Significant Public Health ◽  
Common Risk Factors

Chronic kidney disease (CKD) represents a significant public health burden worldwide and several risk factors have been identified over the years; these have been well-described in the medical literature. Common risk factors such as diabetes mellitus and hypertension will be described in other chapters. While this chapter will focus mainly on CKD risk factors observed in developed countries, several of these are also observed in developing countries. It is now well-established that some risk factors are modifiable while others are non-modifiable. In this chapter, we will explore several of these non-modifiable risk factors in more detail, such as age, gender, race, family history, and low birth weight. But we will also discuss some of the modifiable risk factors such as kidney stones, obstructive sleep apnea, smoking, drugs (excluding NSAIDs), diet, obesity, metabolic syndrome, and hyperuricemia. We will provide a balanced and up to date review of the evidence linking these risk factors with 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 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 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.

Obstructive sleep apnea and hypertension in pediatric chronic kidney disease

2019 ◽  
Vol 34 (11) ◽  
pp. 2361-2370 ◽  
Author(s):  
Anne Tsampalieros ◽  
Henrietta Blinder ◽  
Lynda Hoey ◽  
Franco Momoli ◽  
Nicholas Barrowman ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Obstructive Sleep

Abstract P343: A Dual Endothelin A/B Receptor Blocker in a Rat Model of Sleep Apnea and Chronic Kidney Disease

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Laura V Gonzalez Bosc ◽  
Wieslawa Giermakowska ◽  
Carolyn E Pace ◽  
Adelaeda Barrera ◽  
Perenkita Mendiola ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Receptor Antagonist ◽  
Rat Model ◽  
Experimental Conditions ◽  
Arterial Blood ◽  
Obstructive Sleep ◽  
The Us

Obstructive sleep apnea (OSA) is characterized by recurrent episodes of pharyngeal collapse during sleep resulting in intermittent hypoxia (IH) and sleep fragmentation. OSA affects 5% to 20% of the US population, is associated with high incidence of hypertension, and is a prognostic indicator of accelerated renal failure. More than 20 million people in the US have chronic kidney disease (CKD). In rodents, endothelin-1 (ET-1) contributes to IH-induced hypertension, and ET-1 levels inversely correlate with GFR in end-stage CKD patients. These findings provide the rationale to test the hypothesis that a dual ET receptor antagonist will attenuate the development of hypertension and renal dysfunction in a combined rat model of IH and CKD. Male Sprague Dawley rats received one of three diets: A) control, B) 0.2% adenine, C) 0.2% adenine + 30 mg/kg/day of macitentan (dual ET A /ET B receptor antagonist, Actelion Pharmaceuticals) for 2 weeks followed by 2 weeks of recovery (regular chow or chow+macitentan). Rats were then exposed to sham or IH (20 short exposures/hr to 5% O 2 and 5% CO 2 7 hr/day during sleep) for 4 weeks. Changes in mean arterial blood pressure (MAP) recorded by telemetry are in Figure 1A and estimated glomerular filtration rate in Figure 1B . In summary, macitentan prevents increases in blood pressure caused by CKD, IH and by the combination of CKD+IH. However, it does not improve kidney function. Our data suggest that macitentan could be an effective antihypertensive in CKD patients with irreversible kidney damage as a way to protect the heart, brain and eyes from elevated arterial pressure but it does not reverse toxin-induced tubule atrophy in our experimental conditions.

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