Jin Hean Koh, Claire Yi Jia Lim, Kvan Jie Ming Yam, Brian Sheng Yep Yeo, Adele Chin Wei Ng, Shaun Ray Han Loh, Pon Poh Hsu, Joshua Gooley, Chieh Suai Tan, Song Tar Toh
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Therefore, the objective of this meta-analysis is to assess the bidirectional association between sleep disorders and CKD.</p><p><strong>Methods: </strong>Following a PROSPERO-registered protocol, three blinded reviewers conducted a systematic review of the Medline/PubMed, Embase, Cochrane Library and Cumulative Index of Nursing and Allied Health (CINAHL) databases for observational studies pertaining to the relationship between sleep disorders and CKD. A meta-analysis was conducted in risk ratios (RRs).</p><p><strong>Results: </strong>From 63 studies (26 777 524 patients), OSA [RR 1.68; 95% confidence interval (CI) 1.45 to 1.93], albuminuria (RR 1.54; 95% CI 1.18 to 1.99), restless leg syndrome (RLS) (RR 1.88; 95% CI 1.48 to 2.38) and insomnia (RR 1.24; 95% CI 1.01 to 1.54) were significantly associated with CKD. There was a significant association between OSA (RR 1.77; 95% CI 1.56 to 2.01) with incident CKD. 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引用次数: 0
摘要
背景：已发表的研究表明，慢性肾脏病（CKD）与睡眠障碍之间存在联系，但这种联系的确切性质尚未得到统一描述。明确这种关系有助于采取循证干预措施，解决这些疾病实体之间的相互作用。此类干预措施可以防止阻塞性睡眠呼吸暂停（OSA）加重慢性肾脏病，并通过降低患 OSA 的风险来改善慢性肾脏病患者的生活质量。因此，本荟萃分析旨在评估睡眠障碍与慢性肾脏病之间的双向关联：方法：按照 PROSPERO 注册协议，三位盲审稿人对 Medline/PubMed、Embase、Cochrane Library 和 Cumulative Index of Nursing and Allied Health (CINAHL) 数据库中有关睡眠障碍与 CKD 关系的观察性研究进行了系统性审查。结果：在 63 项研究（26 777 524 名患者）中，OSA [RR 1.68；95% 置信区间 (CI) 1.45 至 1.93]、白蛋白尿（RR 1.54；95% CI 1.18 至 1.99）、不安腿综合征（RLS）（RR 1.88；95% CI 1.48 至 2.38）和失眠（RR 1.24；95% CI 1.01 至 1.54）与慢性肾脏病有显著相关性。OSA（RR 1.77；95% CI 1.56 至 2.01）与慢性肾脏病的发生有明显相关性。与健康对照组相比，慢性肾脏病患者的 OSA（RR 1.74；95% CI 1.55 至 1.96）、RLS（RR 1.73；95% CI 1.32 至 2.25）和失眠（RR 1.14；95% CI 1.03 至 1.27）与慢性肾脏病有明显相关性。此外，慢性肾脏病与OSA的发生也有很大关系（RR 1.60；95% CI 1.35至1.89）：阻塞性睡眠呼吸暂停与慢性阻塞性肺病的双向关系在慢性阻塞性肺病的不同阶段、睡眠障碍的诊断方式和地理区域之间保持一致。据观察，慢性肾脏病与阻塞性睡眠呼吸暂停、RLS 和失眠之间存在双向关联。治疗睡眠障碍可降低患慢性肾脏病的风险，反之亦然。
Bidirectional association of sleep disorders with chronic kidney disease: a systematic review and meta-analysis.
Background: Published studies have suggested a link between chronic kidney disease (CKD) and sleep disorders, although the exact nature of this association has not been uniformly described. Clarifying this relationship may facilitate evidence-based interventions that address the interplay between these disease entities. Such interventions could prevent obstructive sleep apnea (OSA) from worsening CKD and improve the quality of life for CKD patients by reducing the risk of developing OSA. Therefore, the objective of this meta-analysis is to assess the bidirectional association between sleep disorders and CKD.
Methods: Following a PROSPERO-registered protocol, three blinded reviewers conducted a systematic review of the Medline/PubMed, Embase, Cochrane Library and Cumulative Index of Nursing and Allied Health (CINAHL) databases for observational studies pertaining to the relationship between sleep disorders and CKD. A meta-analysis was conducted in risk ratios (RRs).
Results: From 63 studies (26 777 524 patients), OSA [RR 1.68; 95% confidence interval (CI) 1.45 to 1.93], albuminuria (RR 1.54; 95% CI 1.18 to 1.99), restless leg syndrome (RLS) (RR 1.88; 95% CI 1.48 to 2.38) and insomnia (RR 1.24; 95% CI 1.01 to 1.54) were significantly associated with CKD. There was a significant association between OSA (RR 1.77; 95% CI 1.56 to 2.01) with incident CKD. There was a significant association of OSA (RR 1.74; 95% CI 1.55 to 1.96), RLS (RR 1.73; 95% CI 1.32 to 2.25) and insomnia (RR 1.14; 95% CI 1.03 to 1.27) in patients with CKD compared with healthy controls. CKD was also significantly associated with incident OSA (RR 1.60; 95% CI 1.35 to 1.89).
Conclusion: The bidirectional associations of obstructive sleep apnea with CKD remained consistent across different stages of CKD, modes of diagnosis of sleep disorder and geographical region. A bidirectional association was observed between CKD and obstructive sleep apnea, RLS and insomnia. The treatment of sleep disorders may reduce the risk of CKD, and vice versa.
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About the Journal
Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.
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