Treating obstructive sleep apnea (OSA) effectively in patients with chronic kidney disease (CKD) may slow CKD progression, according to the findings of a new study published in Medicine.
Xiaoming Li, MD, of Huazhong University of Science and Technology, Wuhan, China, and colleagues studied 269 patients with stage 3–4 CKD (148 non-OSA cases, 79 mild OSA cases and 42 moderate/severe OSA cases). Investigators administered nasal continuous positive airway pressure (CPAP) treatment for 12 months to 52 OSA patients (32 mild OSA cases and 20 moderate/severe OSA cases). The researchers evaluated variables associated with OSA severity and estimated glomerular filtration rate (eGFR) before and after 12 months of CPAP.
Compared with the CPAP group, the non-CPAP group experienced a significantly greater mean decline in eGFR among those with mild OSA (-3.54 vs -3.14 mL/min/1.73 m2 per year) and moderate/severe OSA (-5.97 vs -2.84 mL/min/1.73 m2 per year). Among moderate/severe OSA patients at 12 months, the CPAP group had a significantly higher mean eGFR than the non-CPAP group (22.5 vs 18.5 mL/min/1.73 m2), and lower level of urine protein (0.26 vs 0.34 g/day). Also at 12 months, the polysomnography results of the CPAP group were significantly improved compared with those of the non-CPAP group.
On multivariate analysis, age, body mass index, apnea-hypopnea index, mean arterial oxygen saturation (SaO2), and SaO2 less than 90% monitoring time were independently associated with reduced eGFR.
Li X, Liu C, Zhanga H, et al. Effect of 12-month nasal continuous positive airway pressure therapy for obstructive sleep apnea on progression of chronic kidney disease. Medicine. 2019; 98:8(e14545); published online ahead of print.