Sleep Apnea and Kidney Failure
- Patients with chronic kidney disease (CKD) are commonly exposed to nighttime hypoxia (deficiency in the amount of oxygen reaching the tissues) that can increase the rate of decline in kidney function
- the prevalence of Obstructive Sleep Apnea (OSA) is much greater in patients with Chronic kidney disease
- OSA can also accelerate loss of kidney function
- mechanisms of OSA-associated renal dysfunction include renal hypoxia, hypertension, endothelial dysfunction, activation of the sympathetic nervous system, and increased oxidative stress.
- most direct pathophysiologic mechanism by which long-standing OSA might contribute to CKD progression is by inducing chronic elevations in BP as a result of increased sympathetic nerve discharge, raising BP during episodes of upper airway occlusion, and sustained elevations in BP during the awake state
- OSA is the leading cause for secondary hypertension
- The deficiency in the amount of oxygen reaching the tissues contributes to an increase in sympathetic activity, renin-angiotensin activity, and oxidative stress, which cause endothelial dysfunction