Sex differences in renal hemodynamics and renin-angiotensin system activity post-CPAP therapy in humans with obstructive sleep apnea
| Autor: | George B. Handley, David Donald McTavish Nicholl, Patrick J. Hanly, Ann Alexandra Zalucky, Sofia B. Ahmed, Darlene Y. Sola |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Renal Plasma Flow Physiology medicine.medical_treatment Renal function 030204 cardiovascular system & hematology Kidney Renin-Angiotensin System 03 medical and health sciences 0302 clinical medicine Cpap therapy Internal medicine Renin–angiotensin system medicine Humans Renal hemodynamics Continuous positive airway pressure Sex Characteristics Sleep Apnea Obstructive Continuous Positive Airway Pressure business.industry Hemodynamics Middle Aged medicine.disease respiratory tract diseases Obstructive sleep apnea Treatment Outcome 030228 respiratory system Cardiology Female business Kidney disease |
| Zdroj: | American Journal of Physiology-Renal Physiology. 318:F25-F34 |
| ISSN: | 1522-1466 1931-857X |
| DOI: | 10.1152/ajprenal.00290.2019 |
| Popis: | Men have faster loss of kidney function and greater renal renin-angiotensin system (RAS) activity compared with women. Obstructive sleep apnea (OSA) is common in chronic kidney disease; the vascular effects of OSA differ by sex, and OSA-associated glomerular hyperfiltration can be reversed by continuous positive airway pressure (CPAP) therapy. We evaluated sex differences in the effect of CPAP on renal hemodynamics and the renal RAS in OSA. Twenty-nine Na+-replete, otherwise healthy study participants with OSA (10 women and 19 men) with nocturnal hypoxemia were studied pre- and post-CPAP (>4 h/night for 4 wk). Renal hemodynamics [renal plasma flow (RPF), glomerular filtration rate (GFR), and filtration fraction(FF)] were measured at baseline and in response to ANG II challenge, as a marker of renal RAS activity, pre- and post-CPAP therapy for 1 mo. In women, CPAP was associated with increased RPF (626 ± 22 vs. 718 ± 43 mL/min, P = 0.007, pre- vs. post-CPAP), maintained GFR (108 ± 2 vs. 105 ± 3 mL/min, P = 0.8), and reduced FF (17.4 ± 0.8% vs. 15.0 ± 0.7%, P = 0.017). In men, CPAP was associated with maintained RPF (710 ± 37 vs. 756 ± 38 mL/min, P = 0.1), maintained GFR (124 ± 8 vs. 113 ± 6 mL/min, P = 0.055), and reduced FF (18.6 ± 1.7% vs. 15.5 ± 1.1%, P = 0.035). Pre-CPAP, there were no sex differences in renal hemodynamic responses to ANG II. CPAP use was associated with a greater renovasoconstrictive response to ANG II in women (RPF at Δ30 min: −100 ± 27 vs. −161 ± 25 mL/min, P = 0.007, and RPF at Δ60 min: −138 ± 27 vs. −206 ± 32 mL/min, P = 0.007) but not men. CPAP use was associated with improved renal hemodynamics in both sexes and downregulated renal RAS activity in women but not men. |
| Databáze: | OpenAIRE |
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