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Sleep Apnea And Kidney Disease

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Medical Sleep
Medical Sleep

This presentation describes the relationship between Sleep Apnea and Kidney Disease.

Gesundheit & Medizin
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Sleep Apnea & Kidney Disease Ed Charnock, M.D Jack Gardner, M.D. Medical Sleep Solutions www.medicalsleep.com
OSA DISCUSSIONS ,[object Object],[object Object],[object Object],[object Object],[object Object]
OSA & OBESITY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
OBESITY No data <10% 10%-14% 15%-19%
OBESITY No Data < 10% 10%-14% 15%-19% 20%-24% 25%-29% ≥ 30%
 
 
OSA & OBESITY ,[object Object],[object Object],[object Object],[object Object],[object Object]
SLEEP APNEA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HTN - OSA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object]
OSA - HTN Epidemiological studies showing association of OSA with HTN are not the proof of causality. Only well done randomized placebo- controlled trials showing that elimination of OSA improves HTN prove that OSA is a cause of HTN.
OSA - HTN ,[object Object],[object Object],[object Object]
OSA - HTN ,[object Object],[object Object],[object Object]
OSA - HTN 9 Prospective Studies; N= 420,000; Mean F/U 10 Y Decrease in DB, mm Hg 5 7.5 10 Decrease in CHD, % 21 29 37 Decrease in stroke, % 34 46 56 Mac Mahon et al. Lancet. 1999
ATHEROSCLEROSIS Kohler, AJRCCM, 2007 Drager, AJRCCM, 2005 Savransky, AJRCCM, 2007
Atherosclerosis ,[object Object],[object Object],[object Object],[object Object]
ARRHYTHMIA Tachy-brady arrhythmias: Most common Atrial: Sinus Arrest, Atrial Fibrillation AV nodal: Complete Heart Block Ventricular: PVC’s. VT Effective CPAP therapy decreases nocturnal arrhythmias (CSA & OSA)
ARRHYTHMIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
100 out of 114 consecutive patients AHI ≥ 5/h (mild) 68% AHI ≥ 15/h (moderate) 49% Javaheri : Ann Intern Med 1995 Circulation 1998 Int J Cardiol 2006
OSA - SHF
 
 
 
[object Object],NPSG
[object Object],CPAP
[object Object],AUTO-SV
SLEEP APNEA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SLEEP APNEA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CKD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CKD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HTN RATE 28% in pts without OSA or CKD 50% in pts with OSA 70% in pts with OSA and CKD Numerous RCT’s in DM & non-DM pts with early renal insufficiency reveal that lowering blood pressure is associated with slowing the progression of CKD.
[object Object],[object Object],[object Object]
CLINICAL ,[object Object],[object Object],[object Object],[object Object],[object Object]
PROCESS
INTERFACES
BENEFITS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ACCREDITED AASM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ed Charnock, M.D echarnock@medicalsleep.com Jack Gardner, M.D. [email_address] Medical Sleep Solutions www.medicalsleep.com

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Sleep Apnea And Kidney Disease

  • 1. Sleep Apnea & Kidney Disease Ed Charnock, M.D Jack Gardner, M.D. Medical Sleep Solutions www.medicalsleep.com
  • 2.
  • 3.
  • 4. OBESITY No data <10% 10%-14% 15%-19%
  • 5. OBESITY No Data < 10% 10%-14% 15%-19% 20%-24% 25%-29% ≥ 30%
  • 6.  
  • 7.  
  • 8.
  • 9.
  • 10.
  • 11.  
  • 12.
  • 13. OSA - HTN Epidemiological studies showing association of OSA with HTN are not the proof of causality. Only well done randomized placebo- controlled trials showing that elimination of OSA improves HTN prove that OSA is a cause of HTN.
  • 14.
  • 15.
  • 16. OSA - HTN 9 Prospective Studies; N= 420,000; Mean F/U 10 Y Decrease in DB, mm Hg 5 7.5 10 Decrease in CHD, % 21 29 37 Decrease in stroke, % 34 46 56 Mac Mahon et al. Lancet. 1999
  • 17. ATHEROSCLEROSIS Kohler, AJRCCM, 2007 Drager, AJRCCM, 2005 Savransky, AJRCCM, 2007
  • 18.
  • 19. ARRHYTHMIA Tachy-brady arrhythmias: Most common Atrial: Sinus Arrest, Atrial Fibrillation AV nodal: Complete Heart Block Ventricular: PVC’s. VT Effective CPAP therapy decreases nocturnal arrhythmias (CSA & OSA)
  • 20.
  • 21. 100 out of 114 consecutive patients AHI ≥ 5/h (mild) 68% AHI ≥ 15/h (moderate) 49% Javaheri : Ann Intern Med 1995 Circulation 1998 Int J Cardiol 2006
  • 23.  
  • 24.  
  • 25.  
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33. HTN RATE 28% in pts without OSA or CKD 50% in pts with OSA 70% in pts with OSA and CKD Numerous RCT’s in DM & non-DM pts with early renal insufficiency reveal that lowering blood pressure is associated with slowing the progression of CKD.
  • 34.
  • 35.
  • 38.
  • 39.
  • 40. Ed Charnock, M.D echarnock@medicalsleep.com Jack Gardner, M.D. [email_address] Medical Sleep Solutions www.medicalsleep.com