Renin-angiotensin system activation: may it increase frequency of obstructive sleep apnea in patients with autosomal dominant polycystic kidney disease?

Purpose Renin-angiotensin system (RAS) hyperactivity is a common entity in both autosomal dominant polycystic kidney disease (ADPKD) and obstructive sleep apnea (OSA). We aimed to investigate the frequency of OSA in adults with ADPKD either with stages 3–4 or stages 1–2 chronic kidney disease (CKD) and evaluate the effect of RAS blockade on OSA in these patients. Methods This is a comparative, prospective, two-center clinical study. Eligible patients with ADPKD were enrolled in a polysomnography (PSG) study. Presence of OSA in patients with ADPKD was compared with individuals who underwent polisomnography study due to OSA symptoms. A subgroup analysis was performed in terms of the presence of OSA in ADPKD with eGFR values lower or higher than 60 ml/min/1.73 m 2 (stages 3–4 and stages 1–2 CKD, respectively). Results Frequency of OSA (65%) was higher than in the general population and similar between the two groups ( p = 0.367). Patients with ADPKD and eGFR ≥ 60 ml/min/1.73 m 2 presented a similar frequency of OSA to the control group ( p = 0.759). However, OSA was significantly more frequent in ADPKD with eGFR