Title:The Links Between Sleep Apnea and Chronic Kidney Disease
VOLUME: 11 ISSUE: 4
Author(s):Marius Balint Gib, Christophe Aron, Svetlana Ilie, Frederic Wallyn, Macha Tetart and Dumitrita Balint Gib
Affiliation:Department of Pulmonary Medicine and Sleep Center, Public Hospital of Dunkerque, Dunkerque, France.
Keywords:Sleep apnea, Hypertension, Renin-angiotensin-aldosterone system, Autonomic nervous system, Chronic kidney
disease.
Abstract:Recent research suggests an association between the development and progression of
chronic kidney disease (CKD) - which affects 10–13% of the general population and leads to high
rates of morbidity - and sleep apnea (SA).
SA impacts 2–4% of middle aged adults through one of its three forms: obstructive (OSA), central
(CSA) and mixed sleep apnea, respectively. SA is associated with sleep fragmentation and hypoxemia
during the apneic phenomena. Sleep fragmentation activates the renin-angiotensin-aldosterone system and the sympathetic
nervous system, and alters the cardiovascular hemodynamic. It also results in the production of free radicals. SA is a risk
factor for CKD progression because it is associated with glomerular hyper-filtration and may be an independent predictor
of proteinuria. More specifically, the treatment of sleep apnea, manifested through one of its three forms - obstructive,
central, and mixed, respectively - can reduce the severity of CKD and delay its progression by reducing CKD risk factors.
This paper discusses the mechanisms that link CKD and sleep apnea, and suggests SA treatments with beneficial effects to
CKD-related cases. Optimizing sleep duration and quality and treating sleep disorders, especially SA, we can reduce the
severity of CKD and the delay of progression.
