A systematic review on the association between obstructive sleep apnea and chronic kidney disease

Umbro, I.; Fabiani, Valerio; Fabiani, Marco; Angelico, Francesco; Ben, Maria Del

doi:10.1016/j.smrv.2020.101337

Cited by 23 publications

(20 citation statements)

References 47 publications

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“…In 2 relatively small studies in OSA patients, nocturnal hypoxemia associated with hyperfiltration and CPAP improved this alteration [44, 45]. A recent meta-analysis of 6 cross-sectional studies and 2 retrospective case-control studies, including 8,795 participants, underlined the strong association between OSA and CKD [5]. However, the nature of this link (causal vs. noncausal) remains uncertain.…”

Section: Sleep Apnea As a Cardiorenal Risk Factormentioning

confidence: 99%

“…Studies at population level show that 3–9% of women and 10–17% of men have a moderate-to-severe SA [3]. Furthermore, SA – particularly the obstructive type – is much frequent in obesity and type 2 diabetes [4], which are the 2 most common causal risk factors for CKD [1], and sleep apnea is exceedingly frequent in the CKD population [5].…”

Section: Introductionmentioning

confidence: 99%

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Sleep Apnea as a Cardiorenal Risk Factor in CKD and Renal Transplant Patients

2021

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Background: Chronic kidney disease (CKD) is a public health priority of increasing concern worldwide. Sleep apnea (SA) of moderate-to-severe degree has a 3–9% prevalence in women and 10–17% in men in the general population. Summary: In CKD patients, the prevalence of SA parallels the decline of the GFR being 27% in CKD patients with a GFR of >60 mL/min/1.73 m2 and 57% in patients with end-stage kidney disease (ESKD). In the early CKD stages, fluid overload is probably the sole risk factor for SA in this population. At more severe CKD stages, disturbed central and peripheral chemosensitivity and the accumulation of uremic toxins might contribute to SA. Still, there is no direct evidence supporting this hypothesis in human studies. Observational studies coherently show that SA is a risk factor for CKD incidence and CKD progression as well as for cardiovascular disease and death in this population. However, there is no randomized clinical trial testing continuous positive airway pressure or other interventions documenting that attenuation of SA may have a favorable effect on renal and cardiovascular outcomes in CKD and ESKD patients. However, most likely, the causal nature of the association between SA and cardiorenal outcomes remains unproven. Renal transplantation is the most effective treatment of SA in patients with ESKD, but this disturbance re-emerges on long-term observation in this population. However, after renal transplantation, SA does not seem to be a predictor of adverse health outcomes.

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Section: Sleep Apnea As a Cardiorenal Risk Factormentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sleep Apnea as a Cardiorenal Risk Factor in CKD and Renal Transplant Patients

2021

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“…The prevalence of OSA is estimated to be 4% in the general population increasing up to 40% in some disease-specific populations, such as in patients suffering from metabolic syndrome [19] , obesity [20] , diabetes mellitus [21] , arterial hypertension [22] , cardiovascular disease [23] , chronic kidney disease [24] and non-alcoholic fatty liver disease [25] . Furthermore, the prevalence of OSA increases with age, race and world region [26] .…”

Section: Obstructive Sleep Apneamentioning

confidence: 99%

Association between non-alcoholic fatty liver disease and obstructive sleep apnea

Umbro¹,

Fabiani²,

Fabiani³

et al. 2020

WJG

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“…Patients with chronic renal failure (CRF) are known to show a high prevalence of obstructive sleep apnea (OSA), which is often under recognized before surgery [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Arteriovenous fistula (AVF) surgery for these patients can be performed under either general anesthesia (GA) or sedation, with more preference for sedation over GA these days [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Jaw Elevation Device vs. Conventional Airway Assist during Sedation in Chronic Kidney Diseases Undergoing Arteriovenous Fistula Surgery: A Randomized Controlled Trial

Lee

Jeong

Jang

et al. 2021

JCM

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Patients with chronic renal failure (CRF) are likely to have obstructive sleep apnea (OSA) underdiagnosed, and maintaining airway patency is important during sedation. This study compared Jaw elevation device (JED) with conventional airway interventions (head lateral rotation, neck extension, oral or nasal airway insertion, and jaw thrust maneuver) during sedation and hypothesized that JED may be effective to open the airway. A total of 73 patients were allocated to a conventional group (n = 39) and a JED group (n = 34). The number of additional airway interventions was the primary outcome. Percentage of patients with no need of additional interventions and apnea-hypopnea index (AHI) were secondary outcomes. The number of additional interventions was significantly less in the JED group compared to the conventional group (0 (0–0) vs. 1 (0–2); p = 0.002). The percentage of patients with no requirement for additional interventions was significantly higher in the JED group compared to the conventional group (76.5% vs. 43.6%; p = 0.004). AHI was significantly lower in the JED group compared to the conventional group (4.5 (1.5–11.9) vs. 9.3 (3.8–21.9), p = 0.015). In conclusion, JED seems to be effective in opening the airway patency during sedation in CRF patients.

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A systematic review on the association between obstructive sleep apnea and chronic kidney disease

Cited by 23 publications

References 47 publications

Sleep Apnea as a Cardiorenal Risk Factor in CKD and Renal Transplant Patients

Sleep Apnea as a Cardiorenal Risk Factor in CKD and Renal Transplant Patients

Association between non-alcoholic fatty liver disease and obstructive sleep apnea

Comparison of Jaw Elevation Device vs. Conventional Airway Assist during Sedation in Chronic Kidney Diseases Undergoing Arteriovenous Fistula Surgery: A Randomized Controlled Trial

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