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Sleep apnea and CKD

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...
July 5, 2016: 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)
Stephanie C Maung, Ammar El Sara, Cherylle Chapman, Danielle Cohen, Daniel Cukor
Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease (CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations...
May 6, 2016: World Journal of Nephrology
Qian Jiang, Tao-Ping Li, Bo Pang, Xiao Wang, Yu-Feng Wang
OBJECTIVE: To evaluate the association between severity of obstructive sleep apnea hypopnea syndrome (OSAHS) without chronic kidney disease (CKD) and serum cystatin C. METHODS: A total of 238 patients with snoring during sleep admitted between January 2012 and June 2015 underwent full-night polysomnography for diagnosis of OSAHS. The patients were divided according to the apnea-hypopnea index (AHI) scores into simple snoring group (AHI<5) and mild (AHI, 5-15), moderate (AHI, 15-30), and severe OSAHS (AHI>30) groups...
March 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Daisuke Hasegawa, Akihito Tanaka, Daijo Inaguma, Eri Ito, Naoki Kamegai, Akiko Kato, Minami Mizutani, Hiroya Shimogushi, Hibiki Shinjo, Yasuhiro Otsuka, Asami Takeda
BACKGROUND: Recently, sleep apnea syndrome (SAS) has been associated with hypertension, cardiovascular disease and death. Patients with chronic kidney disease (CKD) have higher rates of SAS, atherosclerotic complications and death than do patients without CKD. Although the relationship between SAS and atherosclerosis is well known, few papers have described this relationship in humans, especially in CKD patients. PATIENTS AND METHODS: This was a cross-sectional study of 110 clinically stable, non-dialysis patients with CKD who attended a CKD educational program from April 2014 to September 2015...
February 2016: Cardiorenal Medicine
Maria-Eleni Roumelioti, Christos Argyropoulos, Vernon Shane Pankratz, Manisha Jhamb, Filitsa H Bender, Daniel J Buysse, Patrick Strollo, Mark L Unruh
BACKGROUND: Automated peritoneal dialysis (APD) is one of the fastest growing dialysis modalities. It is unknown whether sleep and mood are disturbed while performing repeated overnight exchanges. OBJECTIVES: In this report, we aim to describe and compare the prevalence of sleep-disordered breathing (SDB), periodic limb movements (PLMS), poor sleep quality (SQ), and depression among APD patients compared with stages 3b-5 (estimated glomerular filtration rate ≤44 ml/min/1...
2016: Canadian Journal of Kidney Health and Disease
Neha Sharma, Elizabeth Harvey, Reshma Amin
Sleep-disordered breathing (SDB) is prevalent in children with chronic kidney disease (CKD), and has the potential to worsen vascular and neuro-cognitive health and quality of life. We present 2 children with CKD who experience central sleep apnea and nocturnal hypoventilation and discuss the possible underlying mechanisms in relation to CKD and dialysis.
January 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Gaurav Nigam, Charu Pathak, Muhammad Riaz
BACKGROUND: Obstructive sleep apnea has been widely studied in patients with chronic renal insufficiency; however only a limited number of studies have reviewed the association between central sleep apnea (CSA) and chronic kidney disease (CKD). The objectives of this systematic review were to assess the prevalence of CSA in and its association with CKD in adult patients and to determine if inclusion of the central hypopnea index affected the reported rates for the prevalence of CSA in CKD...
September 2016: Sleep & Breathing, Schlaf & Atmung
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, Robert R Henry, Irl B Hirsch, Paul S Jellinger, Janet B McGill, Jeffrey I Mechanick, Paul D Rosenblit, Guillermo E Umpierrez
No abstract text is available yet for this article.
January 2016: Endocrine Practice
Adam Ogna, Valentina Forni Ogna, José Haba Rubio, Nadia Tobback, Dana Andries, Martin Preisig, Mehdi Tafti, Peter Vollenweider, Gerard Waeber, Pedro Marques-Vidal, Raphaël Heinzer
STUDY OBJECTIVES: To evaluate the association between early stages of chronic kidney disease (CKD) and sleep disordered breathing (SDB), restless legs syndrome (RLS), and subjective and objective sleep quality (SQ). METHODS: Cross-sectional analysis of a general population-based cohort (HypnoLaus). 1,760 adults (862 men, 898 women; age 59.3 (± 11.4) y) underwent complete polysomnography at home. RESULTS: 8.2% of participants had mild CKD (stage 1-2, estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1...
April 1, 2016: Sleep
Saleem Al Mawed, Mark Unruh
PURPOSE OF REVIEW: Obstructive sleep apnea (OSA) has been shown to be an independent risk factor for the development and progression of diabetes mellitus. Interestingly, there is also a strong correlation between OSA and the development and progression of chronic kidney disease (CKD). As diabetes mellitus is the most common cause of CKD, in this review we summarize the current literature regarding this interconnecting relationship between OSA, CKD, and diabetes mellitus. The literature increasingly supports a bidirectional relationship between CKD and OSA among diabetes mellitus patients leading to an increased rate of progression of diabetic nephropathy...
January 2016: Current Opinion in Pulmonary Medicine
Robert Puckrin, Sameena Iqbal, Arnold Zidulka, Murray Vasilevsky, Paul Barre
PURPOSE: Chronic kidney disease (CKD) is associated with a high incidence of obstructive sleep apnea (OSA). We assessed the effect of continuous positive airway pressure (CPAP) on renal function in patients with CKD and OSA. METHODS: In this retrospective cohort study, 42 patients with Stage 3-5 CKD and OSA were stratified into two groups: patients who use CPAP more (average >4 h/night on >70 % of nights) and patients who use CPAP less (average ≤4 h/night on ≤70 % of nights)...
November 2015: International Urology and Nephrology
Sushma M Dharia, Mark L Unruh, Lee K Brown
Sleep is an essential function of life and serves a crucial role in the promotion of health and performance. Poor sleep quality and sleep disorders have been a recurrent finding in patients with chronic kidney disease (CKD). Sleep disorders such as obstructive sleep apnea (OSA) can contribute to hypertension, diabetes, cardiovascular disease, and worsen obesity, all of which are implicated in the etiology of CKD, but CKD itself may lead to OSA. Relationships between CKD/end-stage renal disease (ESRD) and OSA have been the subject of numerous investigations, but central sleep apnea (CSA) also is highly prevalent in CKD/ESRD but remains poorly understood, underdiagnosed, and undertreated in these patients...
July 2015: Seminars in Nephrology
Gary C W Chan, Bing Lam, Desmond Y H Yap, Mary S M Ip, Kar Neng Lai, Sydney C W Tang
BACKGROUND: The prevalence and severity of sleep apnea (SA) in the chronic kidney disease (CKD) population is not well characterized. Recent studies have yielded highly variable prevalence rates due to cohort heterogeneity and interstudy inconsistencies in defining SA. This study sought to determine the association of SA with CKD by recruiting a uniform cohort to undertake overnight polysomnography (PSG). METHODS: A total of 141 male Chinese CKD patients, ages 40-60 years, underwent overnight PSG to delineate the prevalence and severity of SA and nocturnal hypoxemia (NH)...
May 2016: Nephrology, Dialysis, Transplantation
Reshma Amin, Neha Sharma, Khamisa Al-Mokali, Priya Sayal, Suhail Al-Saleh, Indra Narang, Elizabeth Harvey
BACKGROUND: The aim of our study was to ascertain the prevalence and type of sleep-disordered breathing (SDB) in paediatric patients with severe chronic kidney disease (CKD) based on the results of polysomnograms (PSGs). METHODS: Overnight PSGs were conducted on children with CKD stages 3-5 (dialysis dependent). Data were collected on patient demographics from the medical records. Study participants and/or their caregivers completed the paediatric modification of the Epworth Sleepiness Scale Score, the Pediatric Sleep Questionnaire (PSQ) and the Pediatric Quality of Life Inventory at the time of the PSG...
December 2015: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Yehuda Handelsman, Zachary T Bloomgarden, George Grunberger, Guillermo Umpierrez, Robert S Zimmerman, Timothy S Bailey, Lawrence Blonde, George A Bray, A Jay Cohen, Samuel Dagogo-Jack, Jaime A Davidson, Daniel Einhorn, Om P Ganda, Alan J Garber, W Timothy Garvey, Robert R Henry, Irl B Hirsch, Edward S Horton, Daniel L Hurley, Paul S Jellinger, Lois Jovanovič, Harold E Lebovitz, Derek LeRoith, Philip Levy, Janet B McGill, Jeffrey I Mechanick, Jorge H Mestman, Etie S Moghissi, Eric A Orzeck, Rachel Pessah-Pollack, Paul D Rosenblit, Aaron I Vinik, Kathleen Wyne, Farhad Zangeneh
UNLABELLED: The American Association of Clinical Endocrinologists/American College of Endocrinology Medical Guidelines for Clinical Practice are systematically developed statements to assist healthcare professionals in medical decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication...
April 2015: Endocrine Practice
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