REN and Nephropathy: Mechanisms by which OSA may result in kidney damage include intermittent hypoxia, sympathetic nervous system activation, hypertension, diabetes, and activation of the renin–angiotensin system (RAS).[4,24] Robust evidences demonstrated that OSA could lead to hypertension,[25] diabetes,[3] sympathetic nervous system activation,[26] inflammation, oxidative stress,[27] and activation of the RAS.[28]