Effects of continuous positive airway pressure on renal function in adults with obstructive sleep apnea: a systematic review and meta-analysis.

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Sleep and Breathing Pub Date : 2025-02-13 DOI:10.1007/s11325-025-03256-9

Hui-Hui Peng, Chia-Enn Hu, Yueh-Lin Wu, Wen-Te Liu, Cheng-Yu Tsai, Yi-Chun Kuan

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引用次数: 0

Abstract

Purpose: Obstructive sleep apnea (OSA) is associated with increased risk of chronic kidney disease (CKD). OSA is highly prevalent among patients with CKD, suggesting a bidirectional link between the two conditions. Recent studies reported that continuous positive airway pressure (CPAP) may benefit renal function in OSA patients; however, uncertainties regarding their effects persist. Therefore, we examined the effects of CPAP treatment on renal function in adults with OSA.

Methods: We systematically searched PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov for relevant studies from their inception until January 2024. Pooled estimates for all outcomes were calculated using a random-effects model. Primary outcome measures were the estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR).

Results: Four randomized controlled trials (RCTs) and seven non-RCTs (NRCTs) (n = 2,660) were included. Compared with the control group, the CPAP group exhibited a significantly minimal alleviation in eGFR decline in NRCT (mean difference [MD] = 1.95, 95% confidence interval [CI] = 0.80 to 3.11, p < 0.001), but not in RCT (MD = 1.42, 95% CI = - 0.99 to 3.82, p = 0.25). No significant associations were found between CPAP therapy and UACR (MD = - 0.05, 95% CI = - 0.41 to 0.30, p = 0.77).

Conclusion: Current research provides a low to moderate certainty of evidence, suggesting that CPAP therapy has little to no effect on alleviating the decline in renal function. However, further RCTs with larger sample sizes and extended follow-up periods are required.

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持续气道正压对成人阻塞性睡眠呼吸暂停患者肾功能的影响：一项系统回顾和荟萃分析。

目的：阻塞性睡眠呼吸暂停（OSA）与慢性肾脏疾病（CKD）风险增加有关。阻塞性睡眠呼吸暂停在CKD患者中非常普遍，这表明两种疾病之间存在双向联系。最近的研究报道，持续气道正压通气（CPAP）可能有益于OSA患者的肾功能；然而，关于其影响的不确定性仍然存在。因此，我们研究了CPAP治疗对OSA成人肾功能的影响。方法：系统检索PubMed、EMBASE、Cochrane Library、Web of Science和ClinicalTrials.gov网站，检索从网站成立到2024年1月的相关研究。使用随机效应模型计算所有结果的汇总估计。主要结局指标为肾小球滤过率（eGFR）和尿白蛋白与肌酐比值（UACR）。结果：纳入4项随机对照试验（rct）和7项非随机对照试验（NRCTs）（n = 2660）。与对照组相比，CPAP组在NRCT中eGFR下降的缓解作用明显最小（平均差异[MD] = 1.95, 95%可信区间[CI] = 0.80 ~ 3.11, p）。结论：目前的研究提供了低至中等确定性的证据，表明CPAP治疗对缓解肾功能下降的作用很小或没有作用。然而，需要进一步的随机对照试验，样本量更大，随访时间更长。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.