nocturnal hypoxia and loss of kidney function夜间缺氧和肾功能丧失.pdfVIP

Nocturnal Hypoxia and Loss of Kidney Function 1,4 2,4,5 1,2,4 1,2,5 1,2,4 Sofia B. Ahmed *, Paul E. Ronksley , Brenda R. Hemmelgarn , Willis H. Tsai , Braden J. Manns , Marcello Tonelli3,4, Scott W. Klarenbach3,4, Rick Chin1,4, Fiona M. Clement1,4, Patrick J. Hanly1,5 1 Department of Medicine, University of Calgary, Calgary, Alberta, Canada, 2 Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada, 3 Department of Medicine, University of Alberta, Edmonton, Alberta, Canada, 4 Alberta Kidney Disease Network, Calgary, Alberta, Canada, 5 Sleep Centre, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada 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 m2 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% confi