Rationale: Obstructive sleep apnea (OSA) and nocturnal hypoxemia are associated with chronic kidney disease and up-regulation of the renin-angiotensin system (RAS), which is deleterious to renal function. The extent to which the magnitude of RAS activation is influenced by the severity of nocturnal hypoxemia and comorbid obesity has not been determined.
Objectives: To determine the association between the severity of nocturnal hypoxemia and RAS activity and whether this is independent of obesity in patients with OSA.
Methods: Effective renal plasma flow (ERPF) response to angiotensin II (AngII) challenge, a marker of renal RAS activity, was measured by paraaminohippurate clearance technique in 31 OSA subjects (respiratory disturbance index, 51 ± 25 h(-1)), stratified according to nocturnal hypoxemia status (mean nocturnal SaO2, ≥90% [moderate hypoxemia] or <90% [severe hypoxemia]) and 13 obese control subjects.
Measurements And Main Results: Compared with control subjects, OSA subjects demonstrated decreased renovascular sensitivity (ERPF, -153 ± 79 vs. -283 ± 31 ml/min; P = 0.004) (filtration fraction, 5.4 ± 3.8 vs. 7.1 ± 2.6%; P = 0.0025) in response to 60 minutes of AngII challenge (mean ± SD; all P values OSA vs. control). The fall in ERPF in response to AngII was less in patients with severe hypoxemia compared with those with moderate hypoxemia (P = 0.001) and obese control subjects after 30 minutes (P < 0.001) and 60 minutes (P < 0.001) of AngII challenge, reflecting more augmented renal RAS activity. Severity of hypoxemia was not associated with the blood pressure or the systemic circulating RAS component response to AngII.
Conclusions: The severity of nocturnal hypoxemia influences the magnitude of renal, but not the systemic, RAS activation independently of obesity in patients with OSA.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1164/rccm.201502-0383OC | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association of Obstructive Sleep Apnea and Nocturnal Hypoxemia With the Circadian Rhythm of Myocardial Infarction.
J Am Heart Assoc
January 2025
Center for Coronary Artery Disease, Division of Cardiology Beijing Anzhen Hospital, Capital Medical University Beijing China.
Background: The circadian rhythm of myocardial infarction (MI) in patients with obstructive sleep apnea (OSA) remains disputable and no studies have directly evaluated the relationship between nocturnal hypoxemia and the circadian rhythm of MI. The aim of the current study was to evaluate the association of OSA and nocturnal hypoxemia with MI onset during the night.
Methods: Patients with MI in the OSA-acute coronary syndrome (ACS) project (NCT03362385) were recruited.
Changes in the Spatial Structure of Synchronization Connections in EEG During Nocturnal Sleep Apnea.
Clocks Sleep
December 2024
Institute of Physics, Saratov State University, Astrahanskaia, 83, Saratov 410012, Russia.
This study involved 72 volunteers divided into two groups according to the apnea-hypopnea index (AHI): AHI>15 episodes per hour (ep/h) (main group, n=39, including 28 men, median AHI 44.15, median age 47), 0≤AHI≤15ep/h (control group, n=33, including 12 men, median AHI 2, median age 28). Each participant underwent polysomnography with a recording of 19 EEG channels.
View Article and Find Full Text PDFNocturnal pulse oxygen saturation dynamics at simulated high altitude: Predictive value for acute mountain sickness in healthy men born pre-term.
Exp Physiol
January 2025
Department for Automatics, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia.
The physiological sequelae of pre-term birth might influence the responses of this population to hypoxia. Moreover, identifying variables associated with development of acute mountain sickness (AMS) remains a key practically significant area of altitude research. We investigated the effects of pre-term birth on nocturnal oxygen saturation ( ) dynamics and assessed the predictive potential of nocturnal -related metrics for morning AMS in 12 healthy adults with gestational age < 32 weeks (pre-term) and 12 term-born control participants.
View Article and Find Full Text PDFA Single Night in Hypoxia Either with or without Ketone Ester Ingestion Reduces Sleep Quality Without Impacting Next Day Exercise Performance.
Med Sci Sports Exerc
November 2024
Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, BELGIUM.
Background: Sleeping at altitude is highly common in athletes as an integral part of altitude training camps or sport competitions. However, concerns have been raised due to expected negative effects on sleep quality, thereby potentially hampering exercise recovery and next-day exercise performance. We recently showed that ketone ester (KE) ingestion beneficially impacted sleep following strenuous, late evening exercise in normoxia, and alleviated hypoxemia.
View Article and Find Full Text PDFA randomized, crossover trial of one night of oxygen therapy for obstructive sleep apnea in patients with fibrotic interstitial lung disease.
Sleep Breath
January 2025
Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
Background And Objective: There is no satisfactory treatment for obstructive sleep apnea (OSA) in patients with interstitial lung disease (ILD) because of poor tolerance of positive airway pressure (PAP) therapy. Supplemental oxygen therapy has been shown to reduce hypoxemia and is well tolerated in patients with ILD. However, little is known about the effect of nocturnal oxygen supplementation (NOS) on OSA in patients with ILD.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!