Abstract
SESSION TITLE: Sleep Disorders Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: To assess the possible relationships between OSA and renal outcomes analysis. In OSAS, the sleep fragmentation and repetitive episodes of hypoxia/reoxygenation increase sympathetic activity, endothelial dysfunction, oxidative stress, lipid dysregulation and, systemic inflammation with direct effect on renal function. METHODS: We conducted a follow-up prospective study of 55 outpatients (mean aged 52.58±5.17 years) diagnosed with OSA and 26 healthy controls (mean aged 51.19±5.51 years), unselected for the presence of kidney disease. Demographic, anthropometric (weight, height), smoking history, blood pressure, plasma lipid profile: triglycerides (TG), total cholesterol (TC), Low Density Lipoprotein cholesterol (LDLc), High Density Lipoprotein cholesterol (HDLc), blood albumin and glycemia were assessed. Kidney function was determined by serum creatinine and urea, urine Albumin Excretion Rate (AER), Urinary Protein Excretion Estimation (UPEE), urinary Albumin/Creatinine Ratio (ACR), Urea/Creatinine Ratio (UCR), and creatinine clearance, as an estimate of Glomerular Filtration Rate (eGFR), calculated according to the Cockcroft and Gault and Modification of Diet in Renal Disease equation formulas. All subjects underwent cardiorespiratory poligraphy with VitalNight plus Sleep Diagnosis System according to the American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events, version 2.6 recommendations. Before testing, all participants were asked to complete the Epworth Sleepiness Scale (ESS) questionnaire. Statistical analysis included Spearman correlations tests, t test and one-way ANOVA test. RESULTS: In OSAS patients versus control, we found UPEE (p=0.04), ACR (p=0.0008), creatinine clearance (p=0.01), blood albumin (p= 0.01), TC (p=0.006), TG/albumin ratio (p= 0.0003) were significantly higher, meanwhile eGFR (p=0.01) and HDLc (p=0.04) were lower. In OSAS group, correlations are as follows: Apnea/Hypopnea Index (AHI) and TG/HDLc ratio (r=0.27;p=0.04), AHI and HDLc (r=-0.37;p=0.003); Oxygen Desaturation Index (ODI) and creatinine clearance (r=-0.29;p=0.02), ODI and UCR (r=0.37;p=0.004); eGFR and apneas number (r=0.30;p=0.02), the longest duration of oxygen saturation (minutes) (SpO2)£88% (r=-0.25;p=0.05); UPEE and glycemia (r=-0.40;p=0.002), UPEE and LDLc (r=0.41;p=0.001); TG and ACR (r=0.36;p=0.006), TG and AER (r=0.38;p=0.004). CONCLUSIONS: In OSAS patients, eGFR, UPEE, ACR may have predictive value of early stage kidney disease and, should consider screening in patients with OSA. CLINICAL IMPLICATIONS: A better understanding of pathophysiological mechanisms in this association may improve the role of treatment with continous positive airway pressure (CPAP) and reconsider the antioxidants that could attenuate intermittent hypoxia related to kidney disease. DISCLOSURES: No relevant relationships by Mihaela Gloria Martius, source=Web Response no disclosure on file for Roxana Maria Nemeș; No relevant relationships by Ancuta Petrovan, source=Web Response no disclosure on file for Carmen Monica Pop; No relevant relationships by Ligia Puiu, source=Web Response no disclosure on file for Emilia Tabacu
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