The association of obstructive sleep apnea and renal outcomes—a systematic review and meta-analysis

Abstract

BackgroundThe aim of this systematic review and meta-analysis was to summarize the association of obstructive sleep apnea (OSA) with renal outcome.MethodsOur study followed the PRISMA guidelines. Two independent reviewers searched for relevant articles in the databases of Pubmed, the Web of Science and CENTRAL, and conducted study selection and quality assessment. A random-effect model was used to estimate the effects.ResultsA total of 1240 articles were initially identified (Pubmed = 568, Web of Science = 640, CENTRAL = 32). After removal of duplicate articles (n = 415) and irrelevant articles (n = 788), 37 were selected for full-text review, and 18 were finally included in the analysis. Overall, patients diagnosed with OSA were found to have a higher odds ratio (OR) of a poorer renal outcome, with a pooled OR of 1.77 (95% C.I.: 1.37–2.29). The significant association between OSA and a poorer renal outcome was not affected by the medical condition of diabetes mellitus (DM). In addition, we found that OSA was consistently associated with higher albuminuria/proteinuria and a lower estimated glomerular filtration rate (eGFR), with a pooled OR of 1.84 (95% C.I.: 1.24–2.73) and 1.60 (95% C.I.: 1.19–2.16), respectively. A greater OSA severity was also found to be related to a higher OR, with a mild group OR of 1.45 (95% C.I.: 1.19–1.77) and a moderate and severe group OR of 2.39 (95% C.I.: 1.96–2.90).ConclusionsOur study demonstrated that OSA is significantly associated with poorer renal function.

Telmisartan attenuates kidney apoptosis and autophagy-related protein expression levels in an intermittent hypoxia mouse model

“…Our previous study showed that cystatin C, a novel biomarker of kidney impair, was increased in patients with an apnea-hypopnea index of more than 30 events/hour [ 4 ]. A systematic review and meta-analysis concluded the significant association between OSA and higher albuminuria/proteinuria and a lower estimated glomerular filtration rate [ 19 ]. A study indicates that CPAP treatment can improve renal hemodynamics and the downregulation of the renal renin-angiotensin system in OSA patients [ 21 ].…”

Obstructive Sleep Apnea and Inflammation: Proof of Concept Based on Two Illustrative Cytokines

“…Obesity is a major risk factor of OSAS [1,2,3,4,5,6,7], and both of these conditions impose adverse neurocognitive, mood, behavioral, cardiovascular, and metabolic consequences in both children and adults. In addition, as the awareness and consequently the frequency of diagnosing OSAS have increased, a large list of additional OSAS-associated morbidities has been reported, including chronic kidney disease, erectile dysfunction, ocular conditions, Alzheimer disease, nocturia, and even cancer in adults, while in children enuresis and bruxism are frequent adverse consequences [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31]. Efforts are ongoing to develop new and more effective therapies for OSAS based on underlying mechanisms promoting upper airway collapsibility during sleep [32,33].…”

Risk factors for respiratory complications in patients in the perioperative period

“…Также особую группу пациентов составляют пациенты с обструктивным апноэ сна. Развитие респираторных осложнений у данной группы больных происходит в 2 раза чаще, чем у остальных [10]. Использование опиоидных анальгетиков может приводить к явлениям обструкции, удлиняя продолжительность эпизодов обструктивного апноэ сна [11,12].…”