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Open AccessArticle

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

1
Respiratory Unit, Sant’ Andrea Hospital, 13100 Vercelli, Italy
2
Department of Traslational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
3
Department of Traslational Medicine, Nephrology and Kidney Transplant Unit, University of Eastern Piedmont, 28100 Novara, Italy
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(14), 4922; https://doi.org/10.3390/ijerph17144922
Received: 3 June 2020 / Revised: 3 July 2020 / Accepted: 6 July 2020 / Published: 8 July 2020
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. View Full-Text
Keywords: obstructive sleep apnea; C-PAP; creatinine; eGFR obstructive sleep apnea; C-PAP; creatinine; eGFR
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MDPI and ACS Style

Pochetti, P.; Azzolina, D.; Ragnoli, B.; Tillio, P.A.; Cantaluppi, V.; Malerba, M. Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study. Int. J. Environ. Res. Public Health 2020, 17, 4922. https://doi.org/10.3390/ijerph17144922

AMA Style

Pochetti P, Azzolina D, Ragnoli B, Tillio PA, Cantaluppi V, Malerba M. Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study. International Journal of Environmental Research and Public Health. 2020; 17(14):4922. https://doi.org/10.3390/ijerph17144922

Chicago/Turabian Style

Pochetti, Patrizia; Azzolina, Danila; Ragnoli, Beatrice; Tillio, Paolo A.; Cantaluppi, Vincenzo; Malerba, Mario. 2020. "Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study" Int. J. Environ. Res. Public Health 17, no. 14: 4922. https://doi.org/10.3390/ijerph17144922

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