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Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study

Author

Listed:
  • Patrizia Pochetti

    (Respiratory Unit, Sant’ Andrea Hospital, 13100 Vercelli, Italy)

  • Danila Azzolina

    (Department of Traslational Medicine, University of Eastern Piedmont, 28100 Novara, Italy)

  • Beatrice Ragnoli

    (Respiratory Unit, Sant’ Andrea Hospital, 13100 Vercelli, Italy
    Department of Traslational Medicine, University of Eastern Piedmont, 28100 Novara, Italy)

  • Paolo Amedeo Tillio

    (Respiratory Unit, Sant’ Andrea Hospital, 13100 Vercelli, Italy
    Department of Traslational Medicine, University of Eastern Piedmont, 28100 Novara, Italy)

  • Vincenzo Cantaluppi

    (Department of Traslational Medicine, Nephrology and Kidney Transplant Unit, University of Eastern Piedmont, 28100 Novara, Italy)

  • Mario Malerba

    (Respiratory Unit, Sant’ Andrea Hospital, 13100 Vercelli, Italy
    Department of Traslational Medicine, University of Eastern Piedmont, 28100 Novara, Italy)

Abstract

Previous studies showed a bidirectional relationship between renal function decline and obstructive sleep apnea (OSA) syndrome. Continuous Positive Airway Pressure (C-PAP) treatment was shown to preserve the kidney function in OSA patients. This study aims to investigate the progression of long-term renal function in OSA patients treated with different PAP strategies (patients were divided into two groups, fixed C-PAP or other PAP—automatic and bilevel pressure). Comorbidities and 10-years survival were also evaluated. We performed a retrospective, observational, single-center, cohort study, including the first 40 consecutive patients enrolled from 2009 in the Respiratory disease Unit at the Vercelli University Hospital database. The patient inclusion criteria were: age ≥ 18 years with OSA syndrome according to AASM (American Academy of Sleep Medicine) guidelines. Creatinine serum levels (mg/dL) and the estimated Glomerular Filtration Rate (eGFR, mL/min calculated by CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration equation)) were measured at 3 different time points: at baseline, 3 years and 8 years after PAP treatment. The Kaplan–Meier survival curves stratified according to PAP treatment and compliance have been reported together with log-rank test estimation. In our study, we found a significant creatinine serum level reduction after 3 years of fixed C-PAP treatment ( p value = 0.006) when compared to baseline values. However, we observed that the long-term C-PAP benefit was not significant ( p value = 0.060). Our data confirmed the progressive renal function decline in OSA patients, especially in those using other-PAP treatments; nevertheless, OSA treatment with a fixed C-PAP device has shown, in the short term, a significant improvement in renal function. By contrast, in our study, long-term benefits after 8 years are not been demonstrated probably because of the lack of compliance of the patients and the aging effect.

Suggested Citation

  • Patrizia Pochetti & Danila Azzolina & Beatrice Ragnoli & Paolo Amedeo Tillio & Vincenzo Cantaluppi & Mario Malerba, 2020. "Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study," IJERPH, MDPI, vol. 17(14), pages 1-12, July.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:14:p:4922-:d:381852
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    References listed on IDEAS

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    1. Christian Bressen Pipper & Christian Ritz & Hans Bisgaard, 2012. "A versatile method for confirmatory evaluation of the effects of a covariate in multiple models," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 61(2), pages 315-326, March.
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    1. Beatrice Ragnoli & Patrizia Pochetti & Alberto Raie & Mario Malerba, 2021. "Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management," IJERPH, MDPI, vol. 18(17), pages 1-15, September.

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