Abstract: SA-PO329
Association of Biopsy-Proven Diabetic Nephropathy with Obstructive Sleep Apnea-Hypopnea Syndrome
Session Information
- Diabetic Kidney Disease: Clinical Pathology, Diagnostic and Treatment Advances
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Xue, Qin, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Liu, Hui, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Wang, Niansong, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
Background
Both obstructive sleep apnea-hypopnea syndrome (OSAHS) and diabetic kidney disease (DKD) are common disease. As one of the most common microvascular complications of DM, diabetic nephropathy (DN) has become a primary cause of end-stage renal disease (ESRD) worldwide. Previous reports show that patients with severe sleep apnea or sleep-disordered breathing (SDB) were more likely to have diabetes than those without sleep apnea or SDB. However, the correlation of renal pathology of DN with OSAHS is still unclear. The objective of this study is to explore the impact of OSAHS on renal pathology of DN and assess risk factors of OSAHS in patients with DKD.
Methods
We selected 87 patients with DKD who were hospitalized in department of our hospital from September 2020 to February 2023. All participants underwent full-night standard nocturnal polysomnography (PSG) monitoring in the sleep center. The apnea and hypopnea are scored following the definitions of the American Academy of Sleep Medicine guidelines. An apnea hypopnea index (AHI)>5 events/h was consistent with the diagnosis of OSA. 94 CKD Patients without DKD were recruited as control group in this study. Multiple linear regression is used for analysis the risk factors of OSAHS in patients with DKD. 20 biopsy-proven DN patients were divided into two groups based on the level of AHI to analyze the correlation between OSAHS-related parameters and renal pathological features.
Results
The prevalence of OSAHS was 90.8% (79 of 87), with 25.2% (22 of 87) mild, 35.6% (31 of 87) moderate and 29.8% (26 of 87) severe respectively. The Scr (P=0.001) , cystatin C (P=0.030) , 24h urine protein (P=0.006) , AHI (P=0.022) , ODI (P=0.011) , and CT90 (P=0.046) levels in patients of DKD group were significantly higher than those within non DKD group. Multiple linear regression showed that diabetes course (p=0.048), BMI (p=0.042) were independent risk factors for eGFR. CT90 (p<0.001) was an independent risk factor for UACR. Regarding DKD renal pathology, the overall trend was that the higher the severity of OSAHS, the higher the renal interstitial tubule score and arteriolar hyalinosis score.
Conclusion
OSAHS is high prevalence in patients with DKD. Patients with DKD had more severe renal damage and hypoxemia than those without DKD. Patients of diabetic nephropathy with OSAHS tend to have higher risk of renal pathological impairment.