Although study results showed severe obstructive sleep apnea was associated with increased risk for incident chronic kidney disease, the risk was attenuated and no longer statistically significant after adjusting for obesity.
This finding led Kelsie M. Full, PhD, MPH, of the University of Minnesota ,and colleagues to suggest that sleep apnea may not be an independent risk factor for the development of CKD; rather, they contended, the link may be due to higher BMI, a risk factor that is common in patients who have either condition.“To date, the research investigating the association of [obstructive sleep apnea] OSA and poor sleep characteristics with incident CKD has focused primarily on individual dimensions of sleep and has relied upon either previous clinical diagnoses of OSA or self-reported measures of sleep,” the researchers wrote. “It has been estimated that up to 80% of individuals who meet the diagnostic criteria for OSA remain undiagnosed.”
According to Full and colleagues, this – coupled with the fact that patients with obstructive sleep apnea are at increased risk for established CKD risk factors including obesity, hypertension, type 2 diabetes, oxidative stress and inflammation – indicates further investigation is required. “Although epidemiologic and pathophysiologic evidence suggests an association between OSA and risk of incident CKD, understanding of the association remains incomplete,” they argued.