Prevalence of sleep apnoea in non‐dialysis chronic kidney disease patients: A systematic review and meta‐analysis

Huang, Zhuo; Tang, Xi; Zhang, Tao; Qiu, Shi; Xia, Zijing; Fu, Ping

doi:10.1111/nep.13546

Cited by 12 publications

(5 citation statements)

References 38 publications

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“…Patients with CKD and ESKD have very high prevalence of sleep-disordered breathing (1)(2)(3). It is estimated that 50%-80% of these patients suffer from sleep-disordered breathing, compared with 2%-4% of the general population or 20%-30% of patients with other comorbidities such as diabetes or congestive heart failure (1,2,(4)(5)(6)(7). Moreover, poor sleep quality, altered sleep duration, fragmented sleep, excessive daytime sleepiness, restless legs syndrome, and periodic limb movement disorder are very common (2,3,8).…”

Section: Introductionmentioning

confidence: 99%

“…It is estimated that 50%-80% of these patients suffer from sleep-disordered breathing, compared with 2%-4% of the general population or 20%-30% of patients with other comorbidities such as diabetes or congestive heart failure (1,2,(4)(5)(6)(7). Moreover, poor sleep quality, altered sleep duration, fragmented sleep, excessive daytime sleepiness, restless legs syndrome, and periodic limb movement disorder are very common (2,3,8). In the general population, evidence suggests that sleep apnea and insufficient sleep may be associated with cardiovascular events and all-cause mortality (9,10).…”

Section: Introductionmentioning

confidence: 99%

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Association of Sleep Apnea with Mortality in Patients with Advanced Kidney Disease

Jhamb¹,

Ran²,

Abdalla³

et al. 2020

CJASN

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Background and objectivesIn the general population, sleep disorders are associated with mortality. However, such evidence in patients with CKD and ESKD is limited and shows conflicting results. Our aim was to examine the association of sleep apnea with mortality among patients with CKD and ESKD.Design, setting, participants, & measurementsIn this prospective cohort study, 180 patients (88 with CKD stage 4 or 5, 92 with ESKD) underwent in-home polysomnography, and sleep apnea measures such as apnea hypopnea index (AHI) and nocturnal hypoxemia were obtained. Mortality data were obtained from the National Death Index. Cox proportional hazard models were used for survival analysis.ResultsAmong the 180 patients (mean age 54 years, 37% women, 39% with diabetes, 49% CKD with mean eGFR 18±7 ml/min per 1.73 m2), 71% had sleep apnea (AHI>5) and 23% had severe sleep apnea (AHI>30). Median AHI was 13 (range, 4–29) and was not significantly different in patients with advanced CKD or ESKD. Over a median follow-up of 9 years, there were 84 (47%) deaths. AHI was not significantly associated with mortality after adjusting for age, sex, race, diabetes, body mass index, CKD/ESKD status, and kidney transplant status (AHI>30: hazard ratio [HR], 1.5; 95% confidence interval [95% CI], 0.6 to 4.0; AHI >15 to 30: HR, 2.3; 95% CI, 0.9 to 5.9; AHI >5 to 15: HR, 2.1; 95% CI, 0.8 to 5.4, compared with AHI≤5). Higher proportion of sleep time with oxygen saturation <90% and lower mean oxygen saturation were significantly associated with higher mortality in adjusted analysis (HR, 1.4; 95% CI, 1.1 to 1.7; P=0.007 for every 15% higher proportion, and HR, 1.6; 95% CI, 1.2 to 2.1; P=0.003 for every 2% lower saturation, respectively). Sleep duration, sleep efficiency, or periodic limb movement index were not associated with mortality.ConclusionsHypoxemia-based measures of sleep apnea are significantly associated with increased risk of death among advanced CKD and ESKD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of Sleep Apnea with Mortality in Patients with Advanced Kidney Disease

Jhamb¹,

Ran²,

Abdalla³

et al. 2020

CJASN

View full text Add to dashboard Cite

show abstract

“…CKD patients have a significantly higher prevalence of sleep apnoea than the general population. It is estimated that 50–80% of these patients suffer from sleep-disordered breathing, compared to 2–4% of the general population or 20–30% of patients with other co-morbidities such as diabetes or heart failure [ 56 , 57 , 58 ]. The risk of developing SA increases progressively with decreasing GFR, contributing to the loss of renal function and increased cardiovascular risk.…”

Section: Sleep-related Breathing Disorders In Ckdmentioning

confidence: 99%

Lung Dysfunction and Chronic Kidney Disease: A Complex Network of Multiple Interactions

Gembillo

Calimeri

Tranchida

et al. 2023

JPM

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Chronic kidney disease (CKD) is a progressive disease that affects > 10% of the total population worldwide or >800 million people. CKD poses a particularly heavy burden in low- and middle-income countries, which are least able to cope with its consequences. It has become one of the leading causes of death worldwide and is one of the few non-communicable diseases where the number of related deaths has increased over the last two decades. The high number of people affected, and the significant negative impact of CKD should be a reason to increase efforts to improve prevention and treatment. The interaction of lung and kidney leads to highly complex and difficult clinical scenarios. CKD significantly affects the physiology of the lung by altering fluid homeostasis, acid-base balance and vascular tone. In the lung, haemodynamic disturbances lead to the development of alterations in ventilatory control, pulmonary congestion, capillary stress failure and pulmonary vascular disease. In the kidney, haemodynamic disturbances lead to sodium and water retention and the deterioration of renal function. In this article, we would like to draw attention to the importance of harmonising the definitions of clinical events in pneumology and renal medicine. We would also like to highlight the need for pulmonary function tests in routine clinical practise for the management of patients with CKD, in order to find new concepts for pathophysiological based disease-specific management strategies.

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“…In various studies, a significant underestimation of the prevalence was shown in patients who were examined using questionnaires of OSA. Sleep demonstrates the low effectiveness of these tools [26].…”

Section: Outcome Of Interest Was Not Present At Start Of Study There ...mentioning

confidence: 99%

Obstructive sleep apnea risk factor for chronic kidney disease: A systematic review and meta-analysis

Loayza-Castro,

Vásquez-Romero,

Zeñas-Trujillo

et al. 2023

ELECTRON J GEN MED

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Introduction: Obstructive sleep apnea (OSA) is related to chronic kidney disease (CKD), but its association is not fully understood. Objective: To realize a systematic review with meta-analysis to determine the association between OSA and CKD. Methods: Systematic review with meta-analysis of observational studies. The search was carried out in Embase, PubMed/Medline, Scopus, and Web of Science. The data were calculated by the hazard ratio (HR). The heterogeneity was identified by I squared. Results: Five studies were included (n=6,710). The meta-analysis found an association between OSA and CKD (HR=2.00; confidence interval 95%=1.68-2.38). Conclusions: We found an association between OSA and CKD.

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Prevalence of sleep apnoea in non‐dialysis chronic kidney disease patients: A systematic review and meta‐analysis

Cited by 12 publications

References 38 publications

Association of Sleep Apnea with Mortality in Patients with Advanced Kidney Disease

Association of Sleep Apnea with Mortality in Patients with Advanced Kidney Disease

Lung Dysfunction and Chronic Kidney Disease: A Complex Network of Multiple Interactions

Obstructive sleep apnea risk factor for chronic kidney disease: A systematic review and meta-analysis

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