Obstructive sleep apnea, sleep duration and chronic kidney disease in patients with coronary artery disease

Author(s)

Furlan, Sofia F. ^{[1, 2]} ; Sinkunas, Viktor ^[2] ; Damiani, Lucas P. ^[3] ; Santos, Ronaldo B. ^[1] ; Peres, Matheus ^[2] ; Lemos, Pedro A. ^[4] ; Lee, Chi-Hang ^[5] ; Lorenzi-Filho, Geraldo ^[6] ; Drager, Luciano F. ^{[2, 7]}

Affiliation

^[1] Univ Sao Paulo, Programa Posgrad Cardiol, Inst Coracao InCor, Hosp Clin HCFMUSP, Fac Med, Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Fac Med, Unidade Hipertensao, Hosp Clin HCFMUSP, Inst Coracao InCor, Sao Paulo, SP - Brazil

^[3] Res Inst Heart Hosp HCor, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Serv Hemodinam, Inst Coracao InCor, Hosp Clin HCFMUSP, Fac Med, Sao Paulo, SP - Brazil

^[5] Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore - Singapore

^[6] Univ Sao Paulo, Lab Sono, Div Pneumol, Inst Coracao InCor, Hosp Clin HCFMUSP, Fac Med, Sao Paulo, SP - Brazil

^[7] Univ Sao Paulo, Unidade Hipertensao, Disciplina Nefrol, Hosp Clin HCFMUSP, Fac Med, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: Sleep Medicine; v. 84, p. 268-274, AUG 2021.
• Web of Science Citations: 0

Abstract

Y Background: Limited evidence is available addressing the potential role of sleep disorders on renal function. Here, we aimed to explore the associations of obstructive sleep apnea (OSA) and sleep duration (SD) with renal function in subjects with high cardiovascular risk. Methods: Consecutive subjects with coronary artery disease (CAD) underwent clinical evaluation, sleep study to define OSA and one-week wrist actigraphy to objectively measure SD. OSA was defined by an apnea-hypopnea index (AHI) of >15 events/hour. The estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation. We analyzed the associations of OSA and SD with continuous eGFR values and according to the presence of CKD (eGFR<60 mL/min/1.73 m(2)) after adjusting for multiple confounding factors. Results: We studied 242 subjects (62.8% men). The frequency of OSA was 55.4% and the median SD was 412.8 (363.4-457.25) min. There was no difference in the eGFRs between participants with and without OSA (69.3 +/- 19.1 vs. 74.6 +/- 19.3 mL/min/1.73 m(2), p = 0.72) and the rate of eGFR <60 mL/min/1.73 m(2) (34.3% vs. 25.9%; p = 0.21). Similarly, we did not find differences in patients in eGFR for those with SD > 6 h versus SD < 6 h (72.5 +/- 20.3 vs. 71.4 +/- 19.1 mL/min/1.73 m(2), p = 0.72). In the linear regression analysis, AHI was independently associated with an eGFR<60 mL/min/1.73 m(2) in the unadjusted model {[}-0.15 (-0.27 to-0.04)], (P = 0.01), but not in the adjusted models. Analyses of continuous SD or the stratification in SD >= 6 h or <6 h also revealed neutral results on eGFR. Conclusion: OSA severity and SD were not independently associated with CKD in subjects with CAD. (C) 2021 Elsevier B.V. All rights reserved. (AU)

• FAPESP's process: 19/23496-8 - Impact of sleep disorders on hypertension: a multifaceted approach
• Grantee: Luciano Ferreira Drager
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 12/02953-2 - Impact of obstructive sleep apnea and sleep duration on the progression of cardiovascular diseases
• Grantee: Luciano Ferreira Drager
• Support Opportunities: Research Grants - Young Investigators Grants