scholarly journals Nocturnal blood pressure decrease in patients with chronic kidney disease and in healthy controls – significance of obstructive sleep apnea and renal function

2018 ◽  
Vol Volume 11 ◽  
pp. 279-290
Author(s):  
Bodil G Hornstrup ◽  
Pia H Gjoerup ◽  
Jost Wessels ◽  
Thomas G Lauridsen ◽  
Erling B Pedersen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Renal Function ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Healthy Controls ◽  
Blood Pressure Decrease ◽  
Nocturnal Blood Pressure ◽  
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.

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 Effect of Maternal Obstructive Sleep Apnea-Hypopnea on 24-Hour Blood Pressure, Nocturnal Blood Pressure Dipping and Arterial Stiffness in Hypertensive Disorders of Pregnancy

2021 ◽  
Vol 12 ◽  
Author(s):  
Pattaraporn Panyarath ◽  
Noa Goldscher ◽  
Sushmita Pamidi ◽  
Stella S. Daskalopoulou ◽  
Robert Gagnon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Arterial Stiffness ◽  
Hypertensive Disorders Of Pregnancy ◽  
Adjusted Analysis ◽  
Nocturnal Blood Pressure ◽  
Hypertensive Disorders ◽  
Obstructive Sleep ◽  
The Impact

Rationale: Maternal obstructive sleep apnea-hypopnea (OSAH) is associated with hypertensive disorders of pregnancy (HDP). Attenuation of the normal nocturnal blood pressure (BP) decline (non-dipping) is associated with adverse pregnancy outcomes. OSAH is associated with nocturnal non-dipping in the general population, but this has not been studied in pregnancy. We therefore analyzed baseline data from an ongoing RCT (NCT03309826) assessing the impact of OSAH treatment on HDP outcomes, to evaluate the relationship of OSAH to 24-h BP profile, in particular nocturnal BP dipping, and measures of arterial stiffness.Methods: Women with a singleton pregnancy and HDP underwent level II polysomnography. Patients with OSAH (apnea-hypopnea index (AHI) ≥ 5 events/h) then underwent 24-h ambulatory BP monitoring and arterial stiffness measurements (applanation tonometry, SphygmoCor). Positive dipping was defined as nocturnal systolic blood pressure (SBP) dip ≥ 10%. The relationships between measures of OSAH severity, measures of BP and arterial stiffness were evaluated using linear regression analyses.Results: We studied 51 HDP participants (36.5 ± 4.9 years, BMI 36.9 ± 8.6 kg/m2) with OSAH with mean AHI 27.7 ± 26.4 events/h at 25.0 ± 4.9 weeks’ gestation. We found no significant relationships between AHI or other OSA severity measures and mean 24-h BP values, although BP was generally well-controlled. Most women were SBP non-dippers (78.4%). AHI showed a significant inverse correlation with % SBP dipping following adjustment for age, BMI, parity, gestational age, and BP medications (β = −0.11, p = 0.02). Significant inverse correlations were also observed between AHI and DBP (β = −0.16, p = 0.01) and MAP (β = −0.13, p = 0.02) % dipping. Oxygen desaturation index and sleep time below SaO2 90% were also inversely correlated with % dipping. Moreover, a significant positive correlation was observed between carotid-femoral pulse wave velocity (cfPWV) and REM AHI (β = 0.02, p = 0.04) in unadjusted but not adjusted analysis.Conclusion: Blood pressure non-dipping was observed in a majority of women with HDP and OSAH. There were significant inverse relationships between OSAH severity measures and nocturnal % dipping. Increased arterial stiffness was associated with increasing severity of OSAH during REM sleep in unadjusted although not adjusted analysis. These findings suggest that OSAH may represent a therapeutic target to improve BP profile and vascular risk in HDP.

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