title: Adaptive servo-ventilation improves renal function in patients with heart failure.
abstract: BACKGROUND
  Impaired cardiac function and sleep-disordered breathing (SDB) are associated with progression of chronic kidney disease (CKD) in heart failure (HF) patients. Adaptive servo-ventilation (ASV) therapy improves cardiac function in HF patients regardless of the SDB severity through hemodynamic support and prevention of repetitive hypoxic stress. This study was designed to test the hypothesis that ASV therapy improves renal function in HF patients with SDB.
  
  
  RESULTS
  Of 59 consecutively enrolled HF patients, 43 with moderate-to-severe SDB underwent ASV therapy. HF patients were divided into the ASV-treated group (n = 27) and the non-ASV-treated group (n = 16). Estimated glomerular filtration rate (eGFR), echocardiographic parameters, and inflammatory biomarkers were measured before and 12 months after ASV initiation. Improvement in the eGFR was found in the ASV-treated group, but not in the non-ASV-treated group. There was a positive correlation between the increases in eGFR and left ventricular ejection fraction (r = 0.488, p = 0.001). The changes in high-sensitivity C-reactive protein were negatively correlated with change in the eGFR (r = -0.416, p = 0.006).
  
  
  CONCLUSIONS
  ASV therapy could improve renal dysfunction in HF patients through hemodynamic support. Additionally, prevention of SDB with the use of ASV therapy could exert anti-inflammatory effects, which could contribute to the improvement of renal function in HF patients.
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Hondoh 1-1-1, Akita 010-8543, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Koyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Shigenori
authors.initials: S
authors.lastname: Terada
authors.forename: Shin
authors.initials: S
authors.lastname: Makabe
authors.forename: Gen
authors.initials: G
authors.lastname: Igarashi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Nobori
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood / Q000503:physiopathology* / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D012121:Respiration, Artificial / Q000379:methods*; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000097:blood / Q000503:physiopathology* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein