AJKD：睡眠障碍可致慢性肾病恶化

　　Nicolas F. 等人近期发表《美国肾脏病杂志》上的研究表明：睡眠障碍尤其是阻塞性睡眠呼吸暂停发病率高。

　　尽管慢性肾脏疾病现在发病率和对公共卫生影响高，但导致慢性肾脏疾病发展和恶化的因素至今不明。先前只有少量试图去客观的阐释：睡眠障碍在慢性肾脏疾病患者肾衰竭之前就已经出现。新的证据表明睡眠障碍尤其是阻塞性睡眠呼吸暂停发病率高。在睡眠障碍时，由于血管的顺应性和血管内皮功能刺激，可能加重慢性肾脏疾病恶化。睡眠障碍可能是导致慢性肾衰恶化的一个新的危险因素。优化睡眠时间和质量，治疗睡眠障碍可能会减轻病情，延缓慢性肾脏病的进展。

与睡眠相关的拓展阅读：

• AJKD：睡眠障碍可致慢性肾病恶化
• 睡眠呼吸暂停综合征患者脑损伤有性别差异
• HEART RHYTHM:阻塞性睡眠呼吸暂停升高房颤消融后复发率
• AIM：睡眠不足可诱发脂肪细胞胰岛素抵抗
• 睡眠质量差与顽固性高血压有关
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Sleep Disturbances as Nontraditional Risk Factors for Development and Progression of CKD: Review of the Evidence

Abstract

Despite the high prevalence and enormous public health implications of chronic kidney disease (CKD), the factors responsible for its development and progression are incompletely understood. To date, only a few studies have attempted to objectively characterize sleep in patients with CKD prior to kidney failure, but emerging evidence suggests a high prevalence of sleep disorders, particularly obstructive sleep apnea. Laboratory and epidemiologic studies have shown that insufficient sleep and poor sleep quality promote the development and exacerbate the severity of 3 important risk factors for CKD, namely hypertension, type 2 diabetes, and obesity. In addition, sleep disturbances might have a direct effect on CKD through chronobiological alterations in the renin-angiotensin-aldosterone system and sympathetic nervous system activation. The negative impact of sleep disorders on vascular compliance and endothelial function also may have a deleterious effect on CKD. Sleep disturbances therefore may represent a novel risk factor for the development and progression of CKD. Optimizing sleep duration and quality and treating sleep disorders may reduce the severity and delay the progression of CKD.