Sleep Breath DOI 10.1007/s11325-015-1204-0
ORIGINAL ARTICLE
Renal functions in obstructive sleep apnea patients Meral Uyar 1 & Vedat Davutoğlu 2 & Nevhiz Gündoğdu 1 & Deniz Kosovalı 1 & İbrahim Sarı 2
Received: 18 February 2015 / Revised: 9 April 2015 / Accepted: 25 May 2015 # Springer-Verlag Berlin Heidelberg 2015
Abstract Purpose The aim of this study is to investigate possible factors influencing glomerular filtration rate (GFR) in obstructive sleep apnea (OSA). Methods Data of OSA patients admitted to Gaziantep University sleep clinic from January 2005 to January 2010 were retrospectively evaluated. GFR is calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Patients younger than 18 years old were excluded. Results The mean age of OSA (n=634) and control group (n=62) were 51.13±11.61 and 50.69±13.88 years, respectively (p = 0.81). The mean estimated GFR (eGFR) was 90.73±19.59 ml/min/1.73 m2 in OSA patients and 94.14± 18.81 ml/min/1.73 m2 in control subjects (p=0.19). GFR was 84.25±20.87 ml/min/1.73 m2 in patients with left ventricular hypertrophy (LVH) while it was 93.94±18.44 ml/min/ 1.73 m2 in patients without LVH (p=0.00). GFR of male subjects was 92.1±19.23 in OSA and 95.84±20.08 ml/min/ 1.73 m2 in controls (p=0.33). GFR of female and male patients in the OSA were 87.45±20.10 and 92.91±18.02 ml/ min/1.73 m2, respectively (p=0.13). Serum creatinine was higher in OSA patients compared to controls (p=0.01). GFR was 92.30±19.27 in male and 88.33±19.84 ml/min/1.73 m2 in female subjects (p=0.01). GFR was 84.86±19.95 in hypertensive patients while it was 95.11±18.20 ml/min/1.73 m2 in normotensive subjects (p=0.00). GFR was 89.30±19.96 in
* Meral Uyar [email protected] 1
Department of Pulmonary Diseases, Gaziantep University, Gaziantep 27035, Turkey
2
Department of Cardiology, Gaziantep University, Gaziantep 27035, Turkey
patients with metabolic syndrome (MetS) and it was 93.46± 18.68 ml/min/1.73 m2 in patients without MetS (p=0.00). Conclusions GFR values were lower in sleep apneic patients with MetS as well as in patients with hypertension and LVH. Keywords GFR . Sleep-disordered breathing . Metabolic syndrome . Left ventricular hypertrophy . Gender
Introduction Obstructive sleep apnea (OSA) is characterized with repeated apneas and mostly arterial desaturation attacks. It has been suggested that cardiovascular target organ damage due to OSA originates from intermittent hypoxia which in turn leads to oxidative stress, inflammatory state, hemodynamic instability, increased sympathetic activity, and finally endothelial injury [1]. Accordingly, some studies suggested that there is a possible relationship between renal dysfunction and OSA [1–6]. Chou et al. showed that there was a high prevalence of chronic kidney disease in patients with severe OSA even in the absence of hypertension or diabetes [7]. In this aspect, we decided to share the prevalence of renal dysfunction and associated factors in our large cohort of OSA patients. There are various equations used to compute for estimated glomerular filtration rate (eGFR) [8, 9]. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) is a relatively new method which is found to be more accurate in estimating renal functions [10, 11]. Therefore, in the present study, we aimed to evaluate whether there is subclinical renal dysfunction in sleep apneics and the possible association between renal functions and OSA severity along with risk factors for renal dysfunction in a large cohort of patients with different ranges of apnea-hypopnea index (AHI).
Sleep Breath
Material and methods Data of patients who were diagnosed with OSA after referral to the sleep center in Gaziantep University Medical Faculty between January 2005 and January 2010 were retrospectively evaluated. Patients younger than 18 years old were excluded. Sleep studies were performed according to the guidelines of the American Academy of Sleep Medicine [12]. Epworth Sleepiness Scale (ESS) was used for evaluating daytime sleepiness [13]. OSAwas diagnosed with compatible clinical findings and AHI ≥5 [12]. OSA severity was defined as mild, moderate, or severe when AHI was 5–15, 15–30, and ≥30, respectively [12]. Desaturation was defined as 3 % fall in oxygen saturation level, and desaturation index was defined as total number of desaturations per hour [12]. Patients diagnosed with chronic kidney disease were excluded for data analysis. Control group consisted of age-matched patients with AHI
ORIGINAL ARTICLE
Renal functions in obstructive sleep apnea patients Meral Uyar 1 & Vedat Davutoğlu 2 & Nevhiz Gündoğdu 1 & Deniz Kosovalı 1 & İbrahim Sarı 2
Received: 18 February 2015 / Revised: 9 April 2015 / Accepted: 25 May 2015 # Springer-Verlag Berlin Heidelberg 2015
Abstract Purpose The aim of this study is to investigate possible factors influencing glomerular filtration rate (GFR) in obstructive sleep apnea (OSA). Methods Data of OSA patients admitted to Gaziantep University sleep clinic from January 2005 to January 2010 were retrospectively evaluated. GFR is calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Patients younger than 18 years old were excluded. Results The mean age of OSA (n=634) and control group (n=62) were 51.13±11.61 and 50.69±13.88 years, respectively (p = 0.81). The mean estimated GFR (eGFR) was 90.73±19.59 ml/min/1.73 m2 in OSA patients and 94.14± 18.81 ml/min/1.73 m2 in control subjects (p=0.19). GFR was 84.25±20.87 ml/min/1.73 m2 in patients with left ventricular hypertrophy (LVH) while it was 93.94±18.44 ml/min/ 1.73 m2 in patients without LVH (p=0.00). GFR of male subjects was 92.1±19.23 in OSA and 95.84±20.08 ml/min/ 1.73 m2 in controls (p=0.33). GFR of female and male patients in the OSA were 87.45±20.10 and 92.91±18.02 ml/ min/1.73 m2, respectively (p=0.13). Serum creatinine was higher in OSA patients compared to controls (p=0.01). GFR was 92.30±19.27 in male and 88.33±19.84 ml/min/1.73 m2 in female subjects (p=0.01). GFR was 84.86±19.95 in hypertensive patients while it was 95.11±18.20 ml/min/1.73 m2 in normotensive subjects (p=0.00). GFR was 89.30±19.96 in
* Meral Uyar [email protected] 1
Department of Pulmonary Diseases, Gaziantep University, Gaziantep 27035, Turkey
2
Department of Cardiology, Gaziantep University, Gaziantep 27035, Turkey
patients with metabolic syndrome (MetS) and it was 93.46± 18.68 ml/min/1.73 m2 in patients without MetS (p=0.00). Conclusions GFR values were lower in sleep apneic patients with MetS as well as in patients with hypertension and LVH. Keywords GFR . Sleep-disordered breathing . Metabolic syndrome . Left ventricular hypertrophy . Gender
Introduction Obstructive sleep apnea (OSA) is characterized with repeated apneas and mostly arterial desaturation attacks. It has been suggested that cardiovascular target organ damage due to OSA originates from intermittent hypoxia which in turn leads to oxidative stress, inflammatory state, hemodynamic instability, increased sympathetic activity, and finally endothelial injury [1]. Accordingly, some studies suggested that there is a possible relationship between renal dysfunction and OSA [1–6]. Chou et al. showed that there was a high prevalence of chronic kidney disease in patients with severe OSA even in the absence of hypertension or diabetes [7]. In this aspect, we decided to share the prevalence of renal dysfunction and associated factors in our large cohort of OSA patients. There are various equations used to compute for estimated glomerular filtration rate (eGFR) [8, 9]. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) is a relatively new method which is found to be more accurate in estimating renal functions [10, 11]. Therefore, in the present study, we aimed to evaluate whether there is subclinical renal dysfunction in sleep apneics and the possible association between renal functions and OSA severity along with risk factors for renal dysfunction in a large cohort of patients with different ranges of apnea-hypopnea index (AHI).
Sleep Breath
Material and methods Data of patients who were diagnosed with OSA after referral to the sleep center in Gaziantep University Medical Faculty between January 2005 and January 2010 were retrospectively evaluated. Patients younger than 18 years old were excluded. Sleep studies were performed according to the guidelines of the American Academy of Sleep Medicine [12]. Epworth Sleepiness Scale (ESS) was used for evaluating daytime sleepiness [13]. OSAwas diagnosed with compatible clinical findings and AHI ≥5 [12]. OSA severity was defined as mild, moderate, or severe when AHI was 5–15, 15–30, and ≥30, respectively [12]. Desaturation was defined as 3 % fall in oxygen saturation level, and desaturation index was defined as total number of desaturations per hour [12]. Patients diagnosed with chronic kidney disease were excluded for data analysis. Control group consisted of age-matched patients with AHI
