Department of Medicine, Section of Nephrology, Koc University School of Medicine, Istanbul, Turkey.
Cardiovascular Diseases Institute, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.
Sleep Breath. 2023 Oct;27(5):1667-1675. doi: 10.1007/s11325-023-02803-6. Epub 2023 Mar 16.
Obstructive sleep apnea (OSA) is frequently reported among patients with chronic kidney disease resulting in considerable morbidity and mortality. OSA may cause repetitive stimulation of the sympathetic nervous system and elevations in pulmonary artery pressure leading to an elevated risk of cardiac and vascular complications in patients with chronic kidney disease. Furthermore, OSA is associated with progressive worsening of kidney injury and loss of renal function.
In this systematic review and meta-analysis, we evaluated the effect of renal transplantation on the progression of OSA in patients with end-stage kidney disease.
The meta-analysis included eight studies with a total of 401 patients. Findings showed that kidney transplantation does not lead to a statistically significant effect on the apnea-hypopnea index (MD 2.6 events/hr, 95% CI -3.2 to 8.3, p = 0.21), total sleep time (MD 14.7 min/night, 95% CI -8.4 to 37.8, p = 0.76), sleep efficiency (MD 2.5%, 95% CI -1.4 to 6.3, p = 0.57), slow wave sleep (MD 0.4% of total sleep time, 95% CI -7.5 to 8.4, p = 0.05), and rapid eye movement sleep (MD 0.6% of total sleep time, 95% CI -2.2 to 3.3, p = 0.98). There was no statistically significant effect of kidney transplantation on OSA in patients with chronic renal disease.
阻塞性睡眠呼吸暂停（OSA）在慢性肾脏病患者中经常被报道，导致相当大的发病率和死亡率。OSA 可能导致交感神经系统的反复刺激和肺动脉压升高，从而使慢性肾脏病患者发生心脏和血管并发症的风险增加。此外，OSA 与肾功能损害和肾功能丧失的逐渐恶化有关。
在这项系统评价和荟萃分析中，我们评估了肾移植对终末期肾病患者 OSA 进展的影响。
荟萃分析包括 8 项研究，共 401 例患者。研究结果表明，肾移植对呼吸暂停低通气指数（MD 2.6 次/小时，95%CI-3.2 至 8.3，p=0.21）、总睡眠时间（MD 14.7 分钟/夜，95%CI-8.4 至 37.8，p=0.76）、睡眠效率（MD 2.5%，95%CI-1.4 至 6.3，p=0.57）、慢波睡眠（MD 总睡眠时间的 0.4%，95%CI-7.5 至 8.4，p=0.05）和快速眼动睡眠（MD 总睡眠时间的 0.6%，95%CI-2.2 至 3.3，p=0.98）没有统计学意义。肾移植对慢性肾脏病患者的 OSA 没有统计学意义。
