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Does CPAP therapy alter urinary albumin level in adult patients with moderate to severe obstructive sleep apnea syndrome?

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Abstract

Background

Urinary albumin is a marker of cardiovascular morbidity and mortality, and also it has been viewed as a marker for vascular endothelial dysfunction in both the kidneys and systemic vasculature. Lowering urinary albumin is associated with fewer cardiovascular and renal diseases. We investigated the change in urinary albumin after 1 month of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnea syndrome (OSAS).

Methods

Eighteen patients (four females) in the middle-age group with moderate to severe OSAS were enrolled, who received and were compliant to CPAP therapy. Patients did not have a systemic disease or use a medication that could influence urinary albumin. Blood and urine samples were obtained in the morning after polysomnography and after 1 month of CPAP therapy to measure urinary albumin excretion and urinary albumin-to-creatinine ratio.

Results

Urinary albumin excretion (UAE) and urinary albumin/creatinine ratio (UACR) decreased significantly after 1 month of CPAP therapy: UAE at baseline and 1 month, 50 (1.1–174.8) and 22.7 (4.1–55.9); UACR, 27 (18.5–51.6) and 10.6 (4.3–43.1). UAE alteration was significantly associated with proportion of sleep time spent below an SaO2 of 90 %. Serum creatinine, serum total cholesterol, and creatinine clearance also decreased after 1 month of CPAP therapy.

Conclusion

Albuminuria is not rare in patients with OSAS and can be corrected after CPAP therapy. Determination of urinary albumin level is a simple, inexpensive, and noninvasive method that could be a promising biomarker to identify a high-risk population in patients with OSAS who may benefit from closer medical follow-up and preventive therapy.

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Abbreviations

OSAS:

Obstructive sleep apnea syndrome

CPAP:

Continuous positive airway pressure

UAE:

Urinary albumin excretion

UACR:

Urinary albumin/creatinine ratio

AHI:

Apnea–hypopnea index

PSG:

Polysomnography

ICSD-2:

International Classification of Sleep Disorders 2

EEG:

Electroencephalography

EOG:

Elecroocculography

EMG:

Electromyography

ECG:

Electrocardiography

AASM:

American Academy of Sleep Medicine

CC:

Creatinine clearance

BMI:

Body mass index

T90%:

Proportion of sleep time spent below an SaO2 of 90 %

SaO2 :

Oxygen saturation percentage

MAP:

Mean arterial pressure

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. The Department of Sleep Disorders, Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Yenisehir, 35110, Izmir, Turkey

    Zehra Aşuk Yaşar

  2. The Department of Pulmonary Diseases, Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Izmir, Turkey

    Zeynep Zeren Ucar, Cenk Kirakli & Gültekin Tibet

  3. The Department of Pulmonary Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Ahmet Ugur Demir

  4. The Department of Biochemistry Diseases, Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Izmir, Turkey

    Dilek Kalenci

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  1. Zehra Aşuk Yaşar
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Correspondence to Zehra Aşuk Yaşar.

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Yaşar, Z.A., Ucar, Z.Z., Demir, A.U. et al. Does CPAP therapy alter urinary albumin level in adult patients with moderate to severe obstructive sleep apnea syndrome?. Sleep Breath 18, 525–532 (2014). https://doi.org/10.1007/s11325-013-0914-4

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  • DOI: https://doi.org/10.1007/s11325-013-0914-4

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