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Effect of Obstructive Sleep Apnea Treatment on Renal Function in Patients with Cardiovascular Disease.
Related Articles

Effect of Obstructive Sleep Apnea Treatment on Renal Function in Patients with Cardiovascular Disease.

Am J Respir Crit Care Med. 2017 Jul 25;:

Authors: Loffler KA, Heeley E, Freed R, Anderson CS, Brockway B, Corbett A, Chang CL, Douglas JA, Ferrier K, Graham N, Hamilton GS, Hlavac M, McArdle N, McLachlan J, Mukherjee S, Naughton MT, Thien F, Young A, Grunstein RR, Palmer LJ, Woodman RJ, Hanly PJ, McEvoy RD, SAVE investigators

Abstract
RATIONALE: Obstructive sleep apnea (OSA) is associated with impaired renal function, but uncertainty exists over whether OSA treatment can influence renal outcomes.
OBJECTIVES: To determine the effects of continuous positive airway pressure (CPAP) on renal function in subjects with co-existing OSA and cardiovascular disease.
METHODS: This was a substudy of the international Sleep Apnea and cardioVascular Endpoints (SAVE) trial that randomized 2717 patients with moderate-severe OSA and established coronary or cerebrovascular disease to receive CPAP plus usual care, or usual care alone. Renal function and adverse renal events were compared between CPAP treated (n = 102) and usual care (n = 98) groups. Glomerular filtration rate was estimated at randomization and the end of follow-up; urinary albumin:creatinine ratio was measured at study exit.
MEASUREMENTS AND MAIN RESULTS: In 200 substudy participants (mean age 64 years; median 4% oxygen desaturation index, 20 events per hour, mean estimated glomerular filtration rate at baseline 82 mL/min/1.73m2), the median (IQR) change in estimated glomerular filtration rate (mL/min/1.73m2/year) was 1.64 ( 3.45 to 0.740) in the CPAP group and 2.30 ( 4.53 to 0.71) in the usual care group (P = 0.21) after a median period of 4.4 years. There were no between-group differences in end-of-study urinary albumin:creatinine ratio, or the occurrence of serious renal or urinary adverse events during the trial. Level of CPAP adherence did not influence the findings.
CONCLUSIONS: CPAP treatment of OSA in patients with cardiovascular disease does not alter renal function, nor the occurrence of renal adverse events. Clinical trial registration available at www.clinicaltrials.gov, ID NCT00738179.

PMID: 28743190 [PubMed - as supplied by publisher]