Thesis or Dissertation Interleukin-18 and chronic kidney disease in patients with obstructive sleep apnea syndrome

依田, 彩文

17 ( 1 )  , pp.53 - 59 , 2015-12-02 , 日本プライマリ・ケア連合学会
Background: Obstructive sleep apnea syndrome (OSAS) and chronic kidney disease (CKD) are common diseases encountered in primary care. These diseases share the same pathophysiology of chronic inflammation. In recent years, it was reported that the inflammasome participates in chronic inflammation, and interleukin (IL)-18 has received significant attention as an inflammasome marker. IL-18 is also closely associated with renal function, and is a stronger predictive marker of renal function disorder than high-sensitivity C-reactive protein (hsCRP) or IL-6. OSAS is also reported to be an independent risk factor of CKD. However, other basal diseases associated with OSAS and severe renal function disorders may also be CKD risk factors, such as hypertension, diabetes mellitus, and hyperlipidemia. So it should be carefully interpreted. Therefore, we investigated renal function in OSAS patients with no potentially confounding disorders using IL-18. Methods: We assessed OSAS severity (apnea?hypopnea index [AHI]); renal function (estimated glomerular filtration rate); and hsCRP, IL-6, and IL-18 levels in 23 patients newly diagnosed with OSAS and free from other diseases Results: Serum levels of IL-18 demonstrated a significant negative correlated with eGFR (P < 0.05). Conclusions: Even when renal dysfunction is mild, chronic inflammation is present in OSAS patients. We hypothesize that IL-18 is a useful marker to detect chronic inflammation in OSAS patients and that this chronic inflammation contributes to CKD. These results suggest that IL-18 is an associative marker for OSAS and renal function disorder, and can help achieve early treatment intervention in primary care.

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