The effect of CPAP therapy on kidney function in CKD patients with OSA

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dc.contributor.advisorHanly, Patrick Joseph
dc.contributor.advisorAhmed, Sofia Bano
dc.contributor.authorRimke, Alexander
dc.contributor.committeememberPendharkar, Sachin R.
dc.contributor.committeememberChowdhury, Tanvir Turin
dc.date2020-06
dc.date.accessioned2020-01-29T17:33:06Z
dc.date.available2020-01-29T17:33:06Z
dc.date.issued2020-01-28
dc.description.abstractIntroduction: Chronic kidney disease (CKD) is a prevalent disorder with significant consequences on patients’ health outcomes and substantial costs to the healthcare system. Obstructive sleep apnea (OSA) is present in ~40% of CKD patients and may contribute to worsening kidney function. A pilot study to investigate the effects of continuous positive airway pressure (CPAP) on kidney function in patients with CKD and OSA was performed to determine potential effects on health outcomes and feasibility of a larger study. Methods: The study was a randomized, controlled, non-blinded, parallel clinical trial in which CKD patients were screened for OSA. Although a convenience sample of 60 patients with stage 3 and 4 CKD and OSA was planned, recruitment was stopped after 57 patients due to budgetary constraints. Patients were randomized to receive usual medical treatment for CKD or usual treatment and CPAP for 12 months. Home sleep apnea tests were performed at baseline and 12 months and CPAP adherence was monitored throughout the study. Recruiting trends were recorded from July 2015 to July 2018. Estimated glomerular filtration rate (eGFR) and albumin:creatinine ratio (ACR) were recorded every three months for 12 months. Results: 57 patients were randomized from the 1665 patients eligible for the study; however, follow-up data at 12 months was obtained in 51 patients. Recruitment failure occurred primarily due to insufficient recruiters (461 patients) and refused consent (645 patients). While there were no significant differences in eGFR and ACR over 12 months between the two groups, a trend for improvement in eGFR and ACR in patients considered at low risk of progression to end-stage kidney disease occurred. Conclusions: Recruitment of CKD patients with OSA for a clinical trial was challenging, but several strategies may improve enrolment in future studies. Although primary analysis did not show treatment of OSA in patients with stage 3 and 4 CKD improved eGFR and ACR, there was a trend for CPAP to improve these outcomes in patients with a low risk of CKD progression. This pilot randomized controlled trial provides preliminary data to determine if a larger clinical trial is merited and its future design.en_US
dc.identifier.citationRimke, A. (2020). The effect of CPAP therapy on kidney function in CKD patients with OSA (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/37528
dc.identifier.urihttp://hdl.handle.net/1880/111583
dc.language.isoengen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectChronic kidney Diseaseen_US
dc.subjectCKDen_US
dc.subjectObstructive Sleep Apneaen_US
dc.subjectOSAen_US
dc.subjectContinuous positive airway pressureen_US
dc.subjectCPAPen_US
dc.subjectestimated glomerular filtration rateen_US
dc.subjecteGFRen_US
dc.subjectalbumin:creatinine ratioen_US
dc.subjectACRen_US
dc.subject.classificationBiophysics--Medicalen_US
dc.titleThe effect of CPAP therapy on kidney function in CKD patients with OSAen_US
dc.typemaster thesisen_US
thesis.degree.disciplineMedicine – Cardiovascular/Respiratory Scienceen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameMaster of Science (MSc)en_US
ucalgary.item.requestcopytrueen_US
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