Obstructive sleep apnea and chronic kidney disease: open questions on a potential public health problem
The relationship between obstructive sleep apnea (OSA) and chronic kidney disease (CKD) is the object of an increasing interest. OSA and CKD share some common risk factors, like older age and obesity, and both of them have complex interrelationships with conditions like systemic hypertension or diabetes, so that to some extent their joint occurrence may be expected. However, several mechanisms, like sympathetic hyperactivity, apnea-related hypertensive peaks, and oxidative stress with subclinical inflammation and endothelial dysfunction, could account for an independent harmful effect of OSA on the kidney, in addition to effects of comorbidities (1). In the last years, evidence has accumulated from both epidemiological and pathophysiological studies supporting some independent pathogenetic role of OSA in kidney disease.