慢性肾脏病与睡眠呼吸暂停之间的双向关联：一项系统评价和荟萃分析。

Bidirectional association between chronic kidney disease and sleep apnea: a systematic review and meta-analysis.

作者信息

Hansrivijit Panupong, Puthenpura Max M, Ghahramani Nasrollah, Thongprayoon Charat, Cheungpasitporn Wisit

机构信息

Department of Internal Medicine, University of Pittsburgh Medical Center Pinnacle, 504 S. Front St, Suite 3C, Harrisburg, PA, 17104, USA.

Drexel University College of Medicine, Philadelphia, PA, 19129, USA.

出版信息

Int Urol Nephrol. 2021 Jun;53(6):1209-1222. doi: 10.1007/s11255-020-02699-1. Epub 2020 Nov 5.

DOI:10.1007/s11255-020-02699-1

PMID:33155087

Abstract

BACKGROUND

Previous data have suggested a link between chronic kidney disease (CKD) and sleep apnea (SA). However, the prevalence and risk association of both disease entities are not uniformly described.

METHODS

Ovid MEDLINE, EMBASE, and the Cochrane Library were searched for eligible publications that included patients aged ≥ 18 years diagnosed with CKD or SA. Included studies were divided into two cohorts: (1) a cohort of CKD or end-stage kidney disease (ESKD) patients reporting the prevalence of SA or odds ratio (OR) for SA (CKD cohort) and (2) a cohort of SA patients reporting the prevalence of CKD/ESKD or OR for CKD/ESKD (SA cohort).

RESULTS

CKD cohort: Of 16 studies (n = 340,587), the pooled estimated prevalence of SA among CKD/ESKD patients was 47.5% (95% CI 28.8-66.9). The pooled adjusted OR for SA among CKD/ESKD patients was 1.961 (95% CI 1.702-2.260). Male sex, history of diabetes, and lower BMI were associated with increased prevalence of SA. SA cohort: Of 12 studies (n = 3,103,074), the pooled prevalence of CKD/ESKD among patients with SA was 8.2% (95% CI 4.7-13.7), whereas the pooled adjusted OR for CKD/ESKD among patients with SA was 2.088 (95% CI 1.777-2.452). Increasing age, higher BMI, male sex, white race, and history of diabetes were associated with higher prevalence of CKD/ESKD.

CONCLUSION

There was a bidirectional association between CKD/ESKD and SA. Interventions aiming to prevent the progression of either CKD or SA are important.

摘要

背景

既往数据提示慢性肾脏病（CKD）与睡眠呼吸暂停（SA）之间存在关联。然而，这两种疾病的患病率及风险关联尚无统一描述。

方法

检索Ovid MEDLINE、EMBASE和Cochrane图书馆，查找纳入年龄≥18岁、诊断为CKD或SA患者的合格出版物。纳入研究分为两个队列：（1）报告SA患病率或SA比值比（OR）的CKD或终末期肾病（ESKD）患者队列（CKD队列）；（2）报告CKD/ESKD患病率或CKD/ESKD的OR的SA患者队列（SA队列）。

结果

CKD队列：16项研究（n = 340,587）中，CKD/ESKD患者中SA的合并估计患病率为47.5%（95%CI 28.8 - 66.9）。CKD/ESKD患者中SA的合并校正OR为1.961（�5%CI 1.702 - 2.260）。男性、糖尿病史和较低的体重指数与SA患病率增加相关。SA队列：12项研究（n = 3,103,074）中，SA患者中CKD/ESKD的合并患病率为8.2%（95%CI 4.7 - 13.7），而SA患者中CKD/ESKD的合并校正OR为2.088（95%CI 1.777 - 2.452）。年龄增加、较高的体重指数、男性、白种人和糖尿病史与CKD/ESKD较高的患病率相关。