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RESEARCH PRODUCT

Sleep Apnea and the Kidney

Oreste MarroneMaria R. BonsignoreMaria R. Bonsignore

subject

Pulmonary and Respiratory Medicinemedicine.medical_specialty030232 urology & nephrologyRenal functionSettore MED/10 - Malattie Dell'Apparato Respiratoriourologic and male genital diseasesKidney transplantation03 medical and health sciences0302 clinical medicineCPAPInternal medicinemedicineSleep-disordered breathingKidneybusiness.industrySleep apneaIntermittent hypoxiamedicine.diseaseCPAP Hemodialysis Kidney transplantation Renal function Sleep-disordered breathingrespiratory tract diseasesObstructive sleep apneaTransplantationmedicine.anatomical_structureBlood pressure030228 respiratory systemNeurologyHemodialysisCardiologyNeurology (clinical)businessRenal functionKidney disease

description

Abstract Purpose of Review There are some uncertainties about the interactions between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). We critically reviewed recent studies on this topic with a focus on experimental and clinical evidence of bidirectional influences between OSA and CKD, as well as the effects of treatment of either disease. Recent Findings Experimental intermittent hypoxia endangers the kidneys, possibly through activation of inflammatory pathways and increased blood pressure. In humans, severe OSA can independently decrease kidney function. Treatment of OSA by CPAP tends to blunt kidney function decline over time, although its effect may vary. OSA may increase cardiovascular complications and mortality in patients with end-stage renal disease (ESRD), while it seems of little harm after renal transplantation. Excessive fluid removal may explain some of the improvements in OSA severity in ESRD and after transplantation. Summary Severe OSA and CKD do interact negatively, mainly through hypoxia and fluid retention. The moderate mutually interactive benefits that treatment of each disease exerts on the other one warrant further studies to improve patient management.

yearjournalcountryeditionlanguage
2020-07-27Current Sleep Medicine Reports
https://doi.org/10.1007/s40675-020-00176-w