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The impact of Obstructive Sleep Apnea on Chronic Kidney Disease Incidence after Acute Cardiogenic Pulmonary Edema: A sub-analysis of OSA-CARE study.
Recent evidence suggests that obstructive sleep apnea (OSA) is associated
with higher rate of acute cardiogenic pulmonary edema (ACPE) recurrence but whether OSA
may impair the renal function in these patients is not clear.
Evaluate whether OSA may impair the renal function in patients with ACPE after one year follow up
We recruited consecutive cases with confirmed ACPE from the
Emergency Unit Department at Heart Institute (InCor). After usual treatments for ACPE and
clinical stabilization (~30 days), all patients were invited to perform a portable sleep
monitoring (Embletta GoldTM). OSA was defined by an apnea-hypopnea-index (AHI) ≥15
events/hour. We estimated the glomerular filtration rate (eGFR) using the Chronic Kidney
Disease: Epidemiology Consortium (CKD-EPI) equations. We calculated the incidence of
chronic kidney disease (CKD), defined by an eGFR < 60mL/min/1.73m2 after one year follow
A total of 55 patients were studied in this sub-analysis (40% males, mean age:
67±11 years and body mass index [BMI] 27.1(24.6-31.2) Kg/m2. The frequency of OSA was
63.6%. Compared to the baseline, the eGFR presented a strong trend for higher decrease in
the OSA versus no OSA subjects (-5.4 ±15.9 vs. -2.03±21.3 mL/min/1.73m2; p=0.053).
The incidence of CKD was higher in the OSA group (from 82.9 to 91.4%) as compared to no
OSA (from 62.2 to 65%; p=0.05).
OSA is associated with higher CKD incidence in patients who recovered from
an ACPE episode. This finding may partially explain the poor prognosis of patients with OSA
who recovered from a previous ACPE.
Obstructive sleep apnea, renal function, cardiovascular disease
Sofia Fontanello Furlan, Thiago A de Macedo, Glaucylara Geovanini, Múcio T Junior, Luis A Bortolloto, Geraldo Lorenzi-Filho, Luciano Ferreira Drager