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Sleep apnea and CKD

Gaurav Nigam, Macario Camacho, Edward T Chang, Muhammad Riaz
Kidney disorders have been associated with a variety of sleep-related disorders. Therefore, researchers are placing greater emphasis on finding the role of chronic kidney disease (CKD) in the development of obstructive sleep apnea and restless legs syndrome. Unfortunately, the presence of other sleep-related disorders with CKDs and non-CKDs has not been investigated with the same clinical rigor. Recent studies have revealed that myriad of sleep disorders are associated with CKDs. Furthermore, there are a few non-CKD-related disorders that are associated with sleep disorders...
2018: Nature and Science of Sleep
Alan J Garber, Martin J Abrahamson, Joshua I Barzilay, Lawrence Blonde, Zachary T Bloomgarden, Michael A Bush, Samuel Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Vivian A Fonseca, Jeffrey R Garber, W Timothy Garvey, George Grunberger, Yehuda Handelsman, Irl B Hirsch, Paul S Jellinger, Janet B McGill, Jeffrey I Mechanick, Paul D Rosenblit, Guillermo E Umpierrez
A1C = hemoglobin A1C; AACE = American Association of Clinical Endocrinologists; ACCORD = Action to Control Cardiovascular Risk in Diabetes; ACCORD BP = Action to Control Cardiovascular Risk in Diabetes Blood Pressure; ACEI = angiotensin-converting enzyme inhibitor; ADVANCE = Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation; AGI = alpha-glucosidase inhibitor; apo B = apolipoprotein B; ASCVD = atherosclerotic cardiovascular disease; BAS = bile acid sequestrant; BCR-QR = bromocriptine quick release; BMI = body mass index; BP = blood pressure; CCB = calcium channel blocker; CHD = coronary heart disease; CKD = chronic kidney disease; CVD = cardiovascular disease; DASH = Dietary Approaches to Stop Hypertension; DPP4 = dipeptidyl peptidase 4; eGFR = estimated glomerular filtration rate; ER = extended release; FDA = Food and Drug Administration; GLP1 = glucagon-like peptide 1; HDL-C = high-density lipoprotein cholesterol; IMPROVE-IT = Improved Reduction of Outcomes: Vytorin Efficacy International Trial; LDL-C = low-density lipoprotein cholesterol; LDL-P = low-density lipoprotein particle; Look AHEAD = Look Action for Health in Diabetes; NPH = neutral protamine Hagedorn; OSA = obstructive sleep apnea; RCT = randomized controlled trial; SU = sulfonylurea; SGLT2 = sodium glucose cotransporter-2; SMBG = self-monitoring of blood glucose; T2D = type 2 diabetes; TZD = thiazolidinedione; VADT = Veterans Affairs Diabetes Trial...
January 2018: Endocrine Practice
Puja B Parikh, Samantha Novotny, Allen Jeremias, Javed Butler, Jie Yang, Donglei Yin, Luis Gruberg
BACKGROUND: Balloon aortic valvuloplasty (BAV) is often utilized as a bridge prior to surgical or transcatheter aortic valve replacement. Chronic kidney disease (CKD) is commonly present in patients with aortic stenosis, however, its association with outcomes following BAV has not been well studied. Accordingly, we sought to assess the impact of CKD on mortality in adults undergoing BAV. METHODS: The Nationwide Inpatient Sample was screened for hospitalizations involving adults undergoing BAV from 2006 to 2012...
October 26, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Ana C Ricardo, Vivien Goh, Jinsong Chen, Esteban Cedillo-Couvert, Mary Kapella, Bharati Prasad, Sharmila Parvathaneni, Kristen Knutson, James P Lash
INTRODUCTION: In general populations, short and long sleep duration, poor sleep quality and sleep disorders have been associated with increased risk of death. We evaluated these associations in individuals with chronic kidney disease (CKD). METHODS: Prospective cohort study of 1,452 National Health and Nutrition Examination Survey (NHANES) 2005-2008 participants with CKD. CKD was defined by estimated glomerular filtration rate <60 ml/min/1.73m(2) or urine albumin-to-creatinine ratio ≥30 mg/g...
September 2017: KI Reports
Yu-Ji Lee, Hye Ryoun Jang, Wooseong Huh, Yoon-Goo Kim, Dae Joong Kim, Ha Young Oh, Eun Yeon Joo, Jung Eun Lee
STUDY OBJECTIVES: This retrospective study was conducted to evaluate the associations and interactions among obstructive sleep apnea (OSA), chronic kidney disease (CKD), and metabolic syndrome (MS). METHODS: This study included 1,732 subjects (1,482 male and 250 female) in whom OSA was diagnosed by polysomnography. The severity of OSA was defined as mild, moderate, or severe with an apnea-hypopnea index (AHI) score of 5 to < 15, 15 to < 30, and ≥ 30 events/h, respectively...
October 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Márcio G Kiuchi, Shaojie Chen
BACKGROUND: Polymorphic premature ventricular complexes (PVCs) are very common, appearing most frequently in patients with hypertension, obesity, sleep apnea, and structural heart disease. Sympathetic hyperactivity plays a critical role in the development, maintenance, and aggravation of ventricular arrhythmias. Endurance exercise training clearly lowers sympathetic activity in sympatho-excitatory disease states and may be tolerated by patients with chronic kidney disease (CKD). METHODS: We assessed 40 CKD patients with hypertension with polymorphic PVCs...
June 2017: Kidney Research and Clinical Practice
Josef Yayan, Kurt Rasche, Angeliki Vlachou
Chronic kidney disease (CKD) often accompanies obstructive sleep apnea (OSA). A causative connection of the two disease entities is uncertain. However, eliminating OSA improves the prognosis of CKD patients. In the present study we examined a possible relationship between OSA and CKD, and whether there would be a mutual enhancing interaction in the severity of the two diseases. The study was of a retrospective nature and encompassed 382 patients over the period of 1 January 2014-30 June 2015. The OSA diagnosis was supported by a polysomnographic examination in 363 (95...
June 1, 2017: Advances in Experimental Medicine and Biology
Sihao Yang, Yan Ren, Xi Li, Haoming Tian, Zhenmei An, Tao Chen
The case we presented here was a 73-year-old gentleman, who was admitted to endocrinology department due to recurrent fatigue for 1 year. He had medical histories of type 2 diabetes for 18 years and developed CKD 4 years ago. He also suffered from dilated cardiomyopathy, and coronary heart disease, moderate sleep apnea syndrome, primary hypothyroidism, and gout. His treatment regimen was complicated which included Caltrate D and compound α-keto acid (1200 mg calcium/d). Laboratory examination revealed that his serum calcium level elevated, 24-hour urine calcium output decreased, PTH level was suppressed, and 25-hydroxyvitamin D was in normal low range...
2017: Case Reports in Endocrinology
Cláudia Gomes, Lia Oliveira, Rosário Ferreira, Carla Simão
OBJECTIVE: There are few reports describing sleep disturbance (SD) in children on automated peritoneal dialysis (APD), and they are mostly based on the application of questionnaires. As far as we know, only two studies used polysomnography (PSG), the gold standard for the diagnosis of SD. This is the first study assessing SD in children with chronic kidney disease (CKD) on APD in our country. METHODS: This was an observational and descriptive study. Children up to 18 years of age who had undergone APD for a minimum of three months were considered eligible...
April 2017: Sleep Medicine
Robert J Adams, Sarah L Appleton, Andrew Vakulin, Patrick J Hanly, Stephen P McDonald, Sean A Martin, Carol J Lang, Anne W Taylor, R Doug McEvoy, Nick A Antic, Peter G Catcheside, Andrew D Vincent, Gary A Wittert
Study Objectives: To determine the relationship between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). Previous population studies of the association are sparse, conflicting and confined largely to studies of administrative data. Methods: Cross-sectional analysis in unselected participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) study, aged >40 years. Renal data were available for 812 men without a prior OSA diagnosis who underwent full in-home polysomnography (Embletta X100) in 2010-2011...
January 1, 2017: Sleep
Phil Schwab, Amol D Dhamane, Sari D Hopson, Chad Moretz, Srinivas Annavarapu, Kate Burslem, Andrew Renda, Shuchita Kaila
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) often have multiple underlying comorbidities, which may lead to increased health care resource utilization (HCRU) and costs. OBJECTIVE: To describe the comorbidity profiles of COPD patients and examine the associations between the presence of comorbidities and HCRU or health care costs. METHODS: A retrospective cohort study utilizing data from a large US national health plan with a predominantly Medicare population was conducted...
2017: International Journal of Chronic Obstructive Pulmonary Disease
Fahad Aziz, Kunal Chaudhary
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...
November 2016: Cardiorenal Medicine
Lin Dou, Haitao Lan, Daniel J Reynolds, Tina M Gunderson, Rahul Kashyap, Ognjen Gajic, Sean Caples, Guangxi Li, Kianoush B Kashani
BACKGROUND/AIMS: Obstructive sleep apnea (OSA) is a known risk factor for chronic kidney disease (CKD); however, its association with acute kidney injury (AKI) is not well documented. We aimed to study whether OSA is associated with the risk of AKI in the intensive care unit (ICU) setting. METHODS: All consecutive adult Olmsted County, MN residents who were admitted in Mayo Clinic ICUs from January 1, 2010 to December 31, 2010 were screened. Chronic and acute risk factors were collected within the first 48 h of ICU admission...
2017: Nephron
Jianwei Xu, In Young Yoon, Ho Jun Chin
BACKGROUND: The prevalence of sleep-disordered breathing (SDB) in people with chronic kidney disease (CKD) is high. Studies on the effects of sleep apnea (SA) on treatment outcomes have been mostly focused on dialyzed CKD or renal transplant patients. Studies on the effects of SA on all-cause mortality in nondialyzed CKD patients are scarce. METHODS: We enrolled and followed up all adults who were referred for diagnostic testing for sleep apnea between March 2007 and July 2014, had undergone polysomnography, and whose records of serum creatinine levels were available...
November 2016: Sleep Medicine
Nadia Gildeh, Panagis Drakatos, Sean Higgins, Ivana Rosenzweig, Brian D Kent
Obstructive sleep apnea (OSA) causes daytime fatigue and sleepiness, and has an established relationship with cardiovascular and metabolic disease. Recent years have seen the emergence of an evidence base linking OSA with an increased risk of degenerative neurological disease and associated cognitive impairment, an accelerated rate of decline in kidney function with an increased risk of clinically significant chronic kidney disease (CKD), and with a significantly higher rate of cancer incidence and death. This review evaluates the evidence base linking OSA with these seemingly unrelated co-morbidities, and explores potential mechanistic links underpinning their development in patients with OSA, including intermittent hypoxia (IH), sleep fragmentation, sympathetic excitation, and immune dysregulation...
September 2016: Journal of Thoracic Disease
Robert J Adams, Sarah L Appleton, Andrew Vakulin, Patrick J Hanly, Stephen P McDonald, Sean A Martin, Carol J Lang, Anne W Taylor, R Doug McEvoy, Nick A Antic, Peter G Catcheside, Andrew D Vincent, Gary A Wittert
STUDY OBJECTIVES: To determine the relationship between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). Previous population studies of the association are sparse, conflicting and confined largely to studies of administrative data. METHODS: Cross-sectional analysis in unselected participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) study, aged >40 y. Renal data were available on 812 men without a prior OSA diagnosis who underwent full in-home polysomnography (Embletta X100) in 2010-2011...
September 9, 2016: Sleep
F Mallamaci, R Tripepi, M C Versace, F Provenzano, A Mafrica, C Torino, G D'Arrigo, D Leonardis, G Tripepi, C Zoccali
OBJECTIVE: In renal transplant patients, the prevalence of nocturnal hypertension by far exceeds that of hypertension as assessed by clinic, daytime, and average 24-hour ABPM and night-time systolic BP (SBP) and the night-day ratio but no other BP metrics are independently associated with IMT in this population (Transplantation 2015 Dec 17). BP during nighttime may provide information for the assessment of CV risk attributable to BP burden in renal transplant patients but the determinants of this phenomenon are still undefined in these patients...
September 2016: Journal of Hypertension
Judith Giunta, Moro O Salifu, Samy I McFarlane
Obesity is a major public health problem that is reaching pandemic proportion. Currently two thirds of the American population is either overweight or obese and worldwide, 39% of the population is overweight and 13% are considered obese [1,2]. This rapid rise in obesity is associated with increased in diabetes mellitus type 2 (DM2), hypertension (HTN), chronic kidney disease (CKD) and cardiovascular diseases (CVD), the major killer of adults in the USA. Parallel to this epidemic is the rapid rise of sleep disorders such as Obstructive Sleep Apnea (OSA)...
2016: Epidemiology: Current Research
Yu-Sheng Lin, Pi-Hua Liu, Shi-Wei Lin, Li-Pang Chuang, Wan-Jing Ho, Yu-Ting Chou, Kuo-Chang Juan, Min-Tzu Lo, Pao-Hsien Chu, Ning-Hung Chen
BACKGROUNDS: Obstructive sleep apnea (OSA) is common in patients on hemodialysis, but its correlation with chronic kidney disease (CKD) is not clear. We aimed to clarify the relationship between OSA without hypertension or diabetes and incidence of CKD in Taiwan. METHODS: This population-based cohort study consisted of patients with newly diagnosed OSA between 2000 and 2009. The comparison cohort was matched for age, sex, diabetes mellitus, and hypertension. All subjects previously diagnosed with acute or chronic kidney disease were excluded...
March 2017: Sleep & Breathing, Schlaf & Atmung
Chih-Ping Chang, Tsai-Chung Li, Liang-Wen Hang, Shinn-Jye Liang, Jen-Jyn Lin, Che-Yi Chou, Jeffrey J P Tsai, Po-Yen Ko, Chiz-Tzung Chang
Hypertension, blood pressure variation, and resistant hypertension have close relations to sleep apnea, which lead to target organ damage, including the kidney. The complex relationships between sleep apnea and blood pressure cause their interactions with chronic kidney disease ambiguous. The aim of the study was to elucidate the separate and joint effects of sleep apnea, hypertension, and resistant hypertension on chronic kidney disease. A cross-sectional study was done to see the associations of sleep apnea, hypertension, and resistant hypertension with chronic kidney disease in 998 subjects underwent overnight polysomnography without device-therapy or surgery for their sleep-disordered breathing...
June 2016: Medicine (Baltimore)
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