OSA Predicts Kidney Disease in Patients With Hypertension

According to a report in Sleep Medicine, obstructive sleep apnea (OSA) was independently associated with an increased risk of chronic kidney disease (CKD) in patients with hypertension. Additionally, more severe OSA was correlated with higher risk of CKD compared with mild or moderate OSA.

These findings were based on a longitudinal study examining the hypothesis that coexisting OSA and hypertension could be independently linked to risk of CKD. The analysis included patients with hypertension and suspected OSA who completed a polysomnography test.

OSA Linked to Kidney Disease Independent of BMI

After propensity score matching, researchers used Cox hazards models to assess associations with renal impairment. A sensitivity analysis was also performed by stratifying patients with primary aldosteronism, also known as Conn syndrome.

A total of 7961 retrospective patients with hypertension were enrolled, of whom 5022 had OSA and 82% completed follow-up. The primary end point was CKD, defined as proteinuria or an estimated glomerular filtration rate of <60 ml/min per 1.73m².

Over a median follow-up of 3.42 years, 1485 patients with OSA developed CKD, for an incidence of 56.72 per 1000 patient-years. Additionally, authors estimated that patients with OSA and severe OSA had hazard ratios for CKD of 1.21 (95% CI, 1.08-1.35) and 1.27 (95% CI, 1.09-1.47), respectively, compared with patients without OSA.

In their analysis of subgroups stratified by body mass index (BMI), the authors noted that presence of OSA was associated with increased risk of CKD in normal-weight patients as well as overweight and obese patients. This finding suggested that risk of renal impairment was primarily driven by OSA rather than obesity, the authors wrote.

“In summary, OSA is independently associated with a higher risk of functional and structural renal damage in the population with hypertension,” the report concluded. “Therefore, it is of significance to conduct routine renal function screening for patients with OSA, especially in populations with hypertension.”

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