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[The main pathophysiological mechanisms of kidney injury in obstructive sleep apnea syndrome]

P A Zelveian, L G Dgerian

    Terapevticheskii Arkhiv
    |August 7, 2014
    PubMed

    Insights

    Obstructive sleep apnea syndrome (OSAS) causes kidney damage through various mechanisms, including oxidative stress and hormonal imbalances. These effects are worsened by common OSAS comorbidities like hypertension and diabetes.

    Area of Science:

    • Nephrology
    • Sleep Medicine
    • Cardiovascular Science

    Context:

    • Obstructive sleep apnea syndrome (OSAS) is increasingly recognized for its detrimental effects on kidney structure and function.
    • Kidney damage in OSAS patients arises from complex pathophysiological pathways.
    • OSAS-related comorbidities significantly contribute to renal injury.

    Purpose:

    • To elucidate the pathophysiological mechanisms linking OSAS to kidney damage.
    • To identify key factors contributing to renal dysfunction in OSAS.
    • To understand the exacerbating role of OSAS comorbidities on kidney injury.

    Summary:

    • OSAS induces kidney damage via free radical overproduction, impaired NO responses, autonomic nervous system activation, and renin-angiotensin-aldosterone system stimulation.
    • Endothelial dysfunction, renal venous hypertension, and increased atrial natriuretic peptide contribute to elevated intraglomerular pressure and hyperfiltration.
    • Comorbidities such as hypertension, diabetes, metabolic syndrome, and atherosclerosis associated with OSAS can independently or synergistically worsen kidney injury.

    Impact:

    • Highlights the critical link between sleep apnea and kidney disease, emphasizing the need for early diagnosis and intervention.
    • Provides a comprehensive overview of the multifactorial mechanisms underlying OSAS-induced nephropathy.
    • Underscores the importance of managing OSAS comorbidities to prevent or mitigate kidney damage.

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