Analysis Of The Incidence And Related Factors Of Proteinuria In OSAHS Patients

Objective(s): To understand the incidence of combined proteinuria in patients with OSAHS hospitalized in the Sleep Medicine Department of the First People’s Hospital of Yunnan Province,to analyze the relationship between positive urine protein and polysomnographic parameters and renal function indicators,and to explore the risk factors causing proteinuria in patients with OSAHS.Methods: Using a retrospective analysis method,1867 patients with OSAHS who were hospitalized in the Sleep Medicine Department of the First People’s Hospital of Yunnan Province from January 2020 to December 2022 were studied,and their general information,polysomnography parameters,urine routine,and blood biochemical indexes were collected and comparatively analyzed.The study subjects were divided into different gender groups and mild OSAHS,moderate OSAHS,and severe OSAHS groups according to gender and apnea hypoventilation index(AHI)values;and into simple OSAHS group,OSAHS with hypertension group,OSAHS with obesity group,and OSAHS with hypertension and obesity group according to whether they were combined with hypertension and/or obesity.The incidence of urine protein positivity in total OSAHS patients was counted,and differences in the incidence of urine protein positivity and PSG monitoring parameters and renal function indexes were compared among different subgroups.Binary logistic regression was used to analyze risk factors for urinary protein positivity in OSAHS patients.Results: he overall incidence of urinary protein abnormalities(including positive and suspected positive urinary protein)in hospitalized OSAHS patients was 31.3%,with the overall incidence of suspected positive urinary protein being 9.6% and the overall incidence of positive urinary protein being 21.7%.After matching for age,BMI,and AHI,there was no statistical difference in the incidence of positive urine protein between male and female OASHS patients.When comparing the mild,moderate,and severe groups of OSAHS patients,the incidence of positive urine protein(13.9% vs.15.4% vs.26.8%)increased with increasing AHI and was significantly higher in the severe OSAHS group than in the mild and moderate OSAHS groups(P < 0.05),while there was no statistical difference between the mild and moderate groups(P>0.05);the three groups showed a progression from mild to severe BMI,SCr,UA and BNU gradually increased and e GFR gradually decreased between the three groups,among which the differences between groups of BMI,SCr,and UA were statistically significant(P<0.05).The incidence of positive urine protein was significantly higher in the OSAHS with obesity group(41.2%)and the OSAHS with hypertension and obesity group(31.7%)than in the OSAHS with hypertension group(16.5%)and the OSAHS alone group(12.3%),with statistically significant differences(P<0.05);in the order of the OSAHS alone group,the OSAHS with hypertension group,the OSAHS with In the order of OSAHS alone group,OSAHS with hypertension group,OSAHS with hypertension group and obese group,the levels of AHI,Max AT,ST90,SCr,and UA gradually increased,while MSp O2 and LSp O2 gradually decreased,and the differences between groups were statistically significant(P<0.05).e GFR levels were highest in the OSAHS with obesity group and lowest in the OSAHS with hypertension group.Patients with urine protein-positive OSAHS had lower age,MSp O2,LSp O2,and e GFR,but higher BMI,AHI,Max AT,ST90,BUN,SCr,and UA compared with patients with urine protein-negative OSAHS,with statistically significant differences(P<0.05).Binary logistic regression analysis showed that higher BMI(OR=1.065,P=0.013),prolonged Max AT(OR=1.009,P=0.005),decreased MSp O2(OR=1.062,P=0.012),and decreased LSp O2(OR=1.040,P=0.000)were the causes for the development of independent risk factors for positive urine protein.Conclusion(s): 1.The detection rate of positive urine protein in single-center inpatients with OSAHS in Kunming was 21.7%,and gender differences did not affect the occurrence of proteinuria in OSAHS patients.2.Increased AHI,combined hypertension,and combined obesity can lead to increased detection of positive urine protein,with obesity having a more pronounced effect.3.Combined hypertension in OSAHS can aggravate renal function impairment,and combined obesity can cause renal hyperfiltration.4.Positive urine protein may be a biological indicator of the severity of OSAHS.5.Weight gain and increased hypoxia during sleep are the main factors influencing the development of proteinuria in OSAHS patients.