Intrarenal hemodynamic and oxidative stress in patients with obstructive sleep apnea syndrome

• Published in: Sleep & breathing 2015-12, Vol.19 (4), p.1205-1212
• Main Authors: Sardo, L., Palange, P., Di Mario, F., Barbano, B., Gigante, A., Mordenti, M., Steffanina, A., Bonini, M., Amoroso, A., Vaccaro, F., Cianci, R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Continuous Positive Airway Pressure; Correlation analysis; Dentistry; Endothelium, Vascular - physiopathology; Female; Hemodynamics - physiology; Home Care Services; Humans; Hypoxia; Internal Medicine; Kidney - blood supply; Kidney diseases; Male; Medicine; Medicine & Public Health; Middle Aged; Neurology; Original Article; Otorhinolaryngology; Oxidative stress; Oxidative Stress - physiology; Oxygen - blood; Pediatrics; Pneumology/Respiratory System; Polysomnography; Prospective Studies; Renal Artery - physiopathology; Sleep apnea; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - physiopathology; Sleep Apnea, Obstructive - therapy; Statistics as Topic; Ultrasonography, Doppler; Vascular Resistance; Vascular Stiffness - physiology; Vasodilation - physiology
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-015-1140-z

Background Oxygen desaturation and reoxygenation, related to intermittent hypoxia cycles due to upper airway obstruction, are major pathophysiologic features of obstructive sleep apnea syndrome (OSAS) and are thought to be responsible for an increased risk of cardiovascular diseases. Continuous positive airway pressure (CPAP) is therefore considered the gold standard in the management of OSAS. Further data demonstrated a high prevalence of OSAS in patients with altered renal function despite the underlying pathophysiological mechanisms that have not been clarified. This study aims to provide evidence on the reported high prevalence of endothelial dysfunction and alterations of the intrarenal hemodynamic in patients affected by OSAS. Furthermore, we evaluated the effect of a CPAP therapy on these endpoints. Methods Twenty patients were enrolled in a prospective study and underwent ultrasound examination to assess endothelial dysfunction, by collecting brachial flow-mediated dilation (FMD) and intrarenal artery stiffness, pre- and post a 30-day treatment with CPAP. Results Endothelial dysfunction and intrarenal artery stiffness significantly improved in all patients after a month of CPAP. In particular, we observed a significant reduction in the renal resistance index (RI) ( p