Nocturnal hypoxia and loss of kidney function

Sofia B Ahmed, Paul E Ronksley, Brenda R Hemmelgarn, Willis H Tsai, Braden J Manns, Marcello Tonelli, Scott W Klarenbach, Rick Chin, Fiona M Clement, Patrick J Hanly, Sofia B Ahmed, Paul E Ronksley, Brenda R Hemmelgarn, Willis H Tsai, Braden J Manns, Marcello Tonelli, Scott W Klarenbach, Rick Chin, Fiona M Clement, Patrick J Hanly

Abstract

Background: Although obstructive sleep apnea (OSA) is more common in patients with kidney disease, whether nocturnal hypoxia affects kidney function is unknown.

Methods: We studied all adult subjects referred for diagnostic testing of sleep apnea between July 2005 and December 31 2007 who had serial measurement of their kidney function. Nocturnal hypoxia was defined as oxygen saturation (SaO2) below 90% for ≥12% of the nocturnal monitoring time. The primary outcome, accelerated loss of kidney function, was defined as a decline in estimated glomerular filtration rate (eGFR) ≥4 ml/min/1.73 m(2) per year.

Results: 858 participants were included and followed for a mean study period of 2.1 years. Overall 374 (44%) had nocturnal hypoxia, and 49 (5.7%) had accelerated loss of kidney function. Compared to controls without hypoxia, patients with nocturnal hypoxia had a significant increase in the adjusted risk of accelerated kidney function loss (odds ratio (OR) 2.89, 95% confidence interval [CI] 1.25, 6.67).

Conclusion: Nocturnal hypoxia was independently associated with an increased risk of accelerated kidney function loss. Further studies are required to determine whether treatment and correction of nocturnal hypoxia reduces loss of kidney function.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Formation of study cohort and…
Figure 1. Formation of study cohort and criteria for exclusion.
Abbreviations: eGFR, estimated glomerular filtration rate; SCr, serum creatinine; TST90, total sleep time spent with oxygen saturation <90%.

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