Obstructive sleep apnea (OSA) is a common and undertreated condition in patients with chronic kidney disease (CKD). Both physiologic and empiric data suggest that renal hypoxia due to OSA is associated with worsening kidney function. Hospitalized patients are often exposed to multiple nephrotoxins such as antibiotics, contrast agents, and diuretics, which place them at risk for acute worsening of kidney function. This study aims to determine whether immediate diagnosis and treatment of OSA in CKD patients will decrease the incidence of acute kidney injury during hospitalization. The investigators will evaluate the extent to which this effect can be attributed to a decrease in nocturnal hypoxia and improved blood pressure control. Secondary endpoints include hospital length of stay, and a composite outcome comprised of hemodialysis initiation, major cardiovascular events, and mortality.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Tampa general hospital
Tampa, Florida, United States
Incidence of acute kidney injury
incidence of acute kidney injury during hospitalization (defined as an increase in creatinine by 0.5 mg/dl or more)
Time frame: participants will be followed for the duration of hospital stay, an expected average of 5 days
Nocturnal hypoxia
Nocturnal hypoxia, defined as oxygen saturation \< 88%
Time frame: participants will be followed for the duration of hospital stay, an expected average of 5 days
Blood pressure control
Blood pressure control, defined as incidence of SBP \> 160
Time frame: participants will be followed for the duration of hospital stay, an expected average of 5 days
Hospital length of stay
Hospital length of stay
Time frame: participants will be followed for the duration of hospital stay, an expected average of 5 days
composite outcome
Composite outcome of a) Incidence of major cardiovascular event (acute coronary syndrome, major arrhythmia, or exacerbation of CHF), b) Initiation of hemodialysis c)In-hospital mortality
Time frame: participants will be followed for the duration of hospital stay, an expected average of 5 days
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