title: Diabetic kidney disease and obstructive sleep apnea: a new frontier?
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) has been shown to be an independent risk factor for the development and progression of diabetes mellitus. Interestingly, there is also a strong correlation between OSA and the development and progression of chronic kidney disease (CKD). As diabetes mellitus is the most common cause of CKD, in this review we summarize the current literature regarding this interconnecting relationship between OSA, CKD, and diabetes mellitus. The literature increasingly supports a bidirectional relationship between CKD and OSA among diabetes mellitus patients leading to an increased rate of progression of diabetic nephropathy.
  
  
  RESULTS
  There is growing evidence that among patients with diabetes mellitus, OSA may be a strong risk factor for the development of diabetic nephropathy. The treatment of OSA in CKD patients may play a role in attenuating the rate of the progression of CKD.
  
  
  CONCLUSIONS
  Clinicians should have a low threshold for evaluating diabetic patients with CKD for OSA. Further studies examining if treatment of OSA would improve the outcomes of CKD patients in general and diabetic CKD patients in particular are needed.
authors.affiliation: Department of Internal Medicine, Nephrology Division, University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: Saleem
authors.initials: S
authors.lastname: Al Mawed
authors.forename: Mark
authors.initials: M
authors.lastname: Unruh
mesh_terms: D003928:Diabetic Nephropathies / Q000150:complications*; D018450:Disease Progression; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*