title: Does CPAP therapy alter urinary albumin level in adult patients with moderate to severe obstructive sleep apnea syndrome?
abstract: BACKGROUND
  Urinary albumin is a marker of cardiovascular morbidity and mortality, and also it has been viewed as a marker for vascular endothelial dysfunction in both the kidneys and systemic vasculature. Lowering urinary albumin is associated with fewer cardiovascular and renal diseases. We investigated the change in urinary albumin after 1 month of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  Eighteen patients (four females) in the middle-age group with moderate to severe OSAS were enrolled, who received and were compliant to CPAP therapy. Patients did not have a systemic disease or use a medication that could influence urinary albumin. Blood and urine samples were obtained in the morning after polysomnography and after 1 month of CPAP therapy to measure urinary albumin excretion and urinary albumin-to-creatinine ratio.
  
  
  RESULTS
  Urinary albumin excretion (UAE) and urinary albumin/creatinine ratio (UACR) decreased significantly after 1 month of CPAP therapy: UAE at baseline and 1 month, 50 (1.1-174.8) and 22.7 (4.1-55.9); UACR, 27 (18.5-51.6) and 10.6 (4.3-43.1). UAE alteration was significantly associated with proportion of sleep time spent below an SaO2 of 90%. Serum creatinine, serum total cholesterol, and creatinine clearance also decreased after 1 month of CPAP therapy.
  
  
  CONCLUSIONS
  Albuminuria is not rare in patients with OSAS and can be corrected after CPAP therapy. Determination of urinary albumin level is a simple, inexpensive, and noninvasive method that could be a promising biomarker to identify a high-risk population in patients with OSAS who may benefit from closer medical follow-up and preventive therapy.
authors.affiliation: The Department of Sleep Disorders, Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Yenisehir, 35110, Izmir, Turkey, zehraasuk@hotmail.com.
authors.forename: Zehra Aşuk
authors.initials: ZA
authors.lastname: Yaşar
authors.forename: Zeynep Zeren
authors.initials: ZZ
authors.lastname: Ucar
authors.forename: Ahmet Ugur
authors.initials: AU
authors.lastname: Demir
authors.forename: Cenk
authors.initials: C
authors.lastname: Kirakli
authors.forename: Dilek
authors.initials: D
authors.lastname: Kalenci
authors.forename: Gültekin
authors.initials: G
authors.lastname: Tibet
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000628:therapy* / Q000652:urine*; D045422:Continuous Positive Airway Pressure; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012016:Reference Values; D012709:Serum Albumin / Q000378:metabolism*; D020181:Sleep Apnea, Obstructive / Q000145:classification / Q000175:diagnosis / Q000628:therapy* / Q000652:urine*
chemical_list: D012709:Serum Albumin; D003404:Creatinine