{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:22:02Z","timestamp":1790788922405,"version":"4.1.0"},"reference-count":71,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T00:00:00Z","timestamp":1605571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000145","name":"Alberta Innovates \u2013 Health Solutions","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000145","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institute of Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Alberta Health and Wellness and the Universities of Alberta and Calgary"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Study Objectives<\/jats:title>\n                  <jats:p>Nocturnal hypoxemia (NH) in obstructive sleep apnea (OSA) is associated with renal renin\u2013angiotensin\u2013aldosterone system (RAAS) up-regulation and loss of kidney function. Continuous positive airway pressure (CPAP) therapy is associated with RAAS down-regulation, though the impact of NH severity remains unknown. We sought to determine whether NH severity alters the effect of CPAP on renal hemodynamics and RAAS activity in humans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Thirty sodium-replete, otherwise healthy, OSA participants (oxygen desaturation index \u2265 15 h\u22121) with NH (SpO2 &amp;lt; 90% \u2265 12%\/night) were studied pre- and post-CPAP (&amp;gt;4 h\/night\u22194 weeks). NH severity was characterized as moderate (mean SpO2[MSpO2] \u2265 90%; N = 15) or severe (MSpO2 &amp;lt; 90%; N = 15). Glomerular filtration rate (GFR), renal plasma flow (RPF), and filtration fraction (FF) were measured at baseline and in response to angiotensin-II (3 ng\/kg\/min\u221930 min, 6 ng\/kg\/min\u221930 min), a marker of RAAS activity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Pre-CPAP, baseline renal hemodynamics did not differ by NH severity. Pre-CPAP, severe NH participants demonstrated blunted GFR (\u039430 min, \u22129 \u00b1 4 vs 1 \u00b1 3 mL\/min, p = 0.021; \u039460 min, \u22125 \u00b1 5 vs 8 \u00b1 5 mL\/min, p = 0.017) and RPF (\u039430 min, \u2212165 \u00b1 13 vs \u221293 \u00b1 19 mL\/min, p = 0.003; \u039460 min, \u2212208 \u00b1 18 vs \u2212112 \u00b1 22 mL\/min, p = 0.001; moderate vs severe) responses to angiotensin-II. Post-CPAP, severe NH participants demonstrated maintained GFR (112 \u00b1 5 vs 108 \u00b1 3 mL\/min, p = 0.9), increased RPF (664 \u00b1 35 vs 745 \u00b1 34 mL\/min, p = 0.009), reduced FF (17.6 \u00b1 1.4 vs 14.9 \u00b1 0.6%, p = 0.009), and augmented RPF responses to Angiotensin-II (\u039430 min, \u221293 \u00b1 19 vs \u2212138 \u00b1 16 mL\/min, p = 0.009; \u039460 min, \u2212112 \u00b1 22 vs \u2212175 \u00b1 20 mL\/min, p = 0.001; pre- vs post-CPAP), while moderate participants were unchanged.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Correction of severe, but not moderate, NH with CPAP therapy was associated with improved renal hemodynamics and decreased renal RAAS activity in humans with OSA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleep\/zsaa228","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T00:17:23Z","timestamp":1605572243000},"source":"Crossref","is-referenced-by-count":17,"title":["Nocturnal hypoxemia severity influences the effect of CPAP therapy on renal renin\u2013angiotensin\u2013aldosterone system activity in humans with obstructive sleep apnea"],"prefix":"10.1093","volume":"44","author":[{"given":"David D M","family":"Nicholl","sequence":"first","affiliation":[{"name":"Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J","family":"Hanly","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada"},{"name":"Sleep Centre, Foothills Medical Centre, Calgary, AB, Canada"},{"name":"Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann A","family":"Zalucky","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George B","family":"Handley","sequence":"additional","affiliation":[{"name":"Healthy Heart Sleep Company, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darlene Y","family":"Sola","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia B","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada"},{"name":"Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada"},{"name":"Alberta Kidney Disease Network, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,17]]},"reference":[{"issue":"2","key":"2021051408592714100_CIT0001","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1056\/NEJM200101113440204","article-title":"Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis","volume":"344","author":"Hanly","year":"2001","journal-title":"N Engl J Med."},{"issue":"6","key":"2021051408592714100_CIT0002","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1378\/chest.11-1809","article-title":"Declining kidney function increases the prevalence of sleep apnea and nocturnal hypoxia","volume":"141","author":"Nicholl","year":"2012","journal-title":"Chest."},{"issue":"5","key":"2021051408592714100_CIT0003","doi-asserted-by":"crossref","first-page":"995","DOI":"10.2215\/CJN.08670910","article-title":"High prevalence of obstructive sleep apnea and its association with renal function among nondialysis chronic kidney disease patients in Japan: a cross-sectional study","volume":"6","author":"Sakaguchi","year":"2011","journal-title":"Clin J Am Soc Nephrol."},{"issue":"4","key":"2021051408592714100_CIT0004","doi-asserted-by":"crossref","first-page":"e19029","DOI":"10.1371\/journal.pone.0019029","article-title":"Nocturnal hypoxia and loss of kidney function","volume":"6","author":"Ahmed","year":"2011","journal-title":"PLoS One."},{"issue":"9","key":"2021051408592714100_CIT0005","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.2215\/CJN.11931112","article-title":"Association of nocturnal hypoxemia with progression of CKD","volume":"8","author":"Sakaguchi","year":"2013","journal-title":"Clin J Am Soc Nephrol."},{"issue":"14","key":"2021051408592714100_CIT0006","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1001\/jama.283.14.1829","article-title":"Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. 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