Scholarlink

Study Objectives: <p>Obstructive sleep apnea-related hypoxemia, measured by hypoxic burden (HB), is associated with chronic kidney disease (CKD). Obstructive sleep apnea-related autonomic response may also be associated with CKD. This study examined whether individuals with high HB and varying autonomic responses to obstructive sleep apnea have a different risk of CKD progression compared to those with low HB.</p> Methods: <p>Polysomnography data from the multicenter Canadian Sleep and Circadian Network cohort were analyzed. HB was defined as the area under event-related oxygen desaturation curves during sleep. Autonomic responses were assessed using “vasoconstriction burden” (area under photoplethysmography declines, reflecting vascular reactivity) and heart rate response to events (reflecting cardiac autonomic response). Estimated glomerular filtration rate and urine albumin:creatinine ratio were used to identify participants at risk of CKD progression. This risk was compared across individuals with high HB (≥ median) and varying levels of autonomic responses relative to those with low HB.</p> Results: <p>Data from 421 participants were analyzed. The odds ratio of CKD progression was higher in those with high vs low HB. Compared to the low HB group, individuals with high HB and low vasoconstriction burden (lowest quartile) were at increased risk of CKD progression (odds ratio [95% confidence interval] = 2.49 [1.23, 5.05]), whereas the risk was not significantly elevated in those with the high vasoconstriction burden (highest quartile). In contrast, within high HB, both high (highest quartile) and low heart rate response (lowest quartile) groups were at increased risk of CKD progression compared to those with low HB.</p> Conclusions: <p>Autonomic response to respiratory events improves risk stratification for CKD progression in obstructive sleep apnea. Vasoconstriction burden and heart rate response show distinct associations with this risk.</p> Citation: <p>Hajipour M, Beaudin AE, Hicks JB, et&#xa0;al. Autonomic responses to respiratory events and risk of chronic kidney disease in obstructive sleep apnea. <i>J Clin Sleep Med</i>. 2025;21(12):2041–2050.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Autonomic responses to respiratory events and risk of chronic kidney disease in obstructive sleep apnea

  • 期刊论文

  • 发表日期：

    2025年12月1日

查看全文
  • Mohammadreza Hajipour,
  • Andrew E. Beaudin,
  • Joshua B. Hicks,
  • Ali Abdul Ghafoor,
  • Jill K. Raneri,
  • AJ Hirsch Allen,
  • Zahra Izadi,
  • Rachel Jen,
  • Tetyana Kendzerska,
  • Fréderic Series,
  • Robert P. Skomro,
  • Rebecca Robillard,
  • R. John Kimoff,
  • Sidney Fels,
  • Amrit Singh,
  • Sofia B. Ahmed,
  • Ali Azarbarzin,
  • Najib T. Ayas,
  • Patrick J. Hanly

摘要

Study Objectives:

Obstructive sleep apnea-related hypoxemia, measured by hypoxic burden (HB), is associated with chronic kidney disease (CKD). Obstructive sleep apnea-related autonomic response may also be associated with CKD. This study examined whether individuals with high HB and varying autonomic responses to obstructive sleep apnea have a different risk of CKD progression compared to those with low HB.

Methods:

Polysomnography data from the multicenter Canadian Sleep and Circadian Network cohort were analyzed. HB was defined as the area under event-related oxygen desaturation curves during sleep. Autonomic responses were assessed using “vasoconstriction burden” (area under photoplethysmography declines, reflecting vascular reactivity) and heart rate response to events (reflecting cardiac autonomic response). Estimated glomerular filtration rate and urine albumin:creatinine ratio were used to identify participants at risk of CKD progression. This risk was compared across individuals with high HB (≥ median) and varying levels of autonomic responses relative to those with low HB.

Results:

Data from 421 participants were analyzed. The odds ratio of CKD progression was higher in those with high vs low HB. Compared to the low HB group, individuals with high HB and low vasoconstriction burden (lowest quartile) were at increased risk of CKD progression (odds ratio [95% confidence interval] = 2.49 [1.23, 5.05]), whereas the risk was not significantly elevated in those with the high vasoconstriction burden (highest quartile). In contrast, within high HB, both high (highest quartile) and low heart rate response (lowest quartile) groups were at increased risk of CKD progression compared to those with low HB.

Conclusions:

Autonomic response to respiratory events improves risk stratification for CKD progression in obstructive sleep apnea. Vasoconstriction burden and heart rate response show distinct associations with this risk.

Citation:

Hajipour M, Beaudin AE, Hicks JB, et al. Autonomic responses to respiratory events and risk of chronic kidney disease in obstructive sleep apnea. J Clin Sleep Med. 2025;21(12):2041–2050.