Abstract: SA-PO418

The Prevalence of Sleep Apnea in Non-Dialysis CKD Patients: A Systematic Review and Meta-Analysis

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 302 CKD: Estimating Equations, Incidence, Prevalence, Special Populations

Authors

  • Huang, Zhuo, Kidney Research Institute, Division of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China
  • Tang, Xi, Kidney Research Institute, Division of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China
  • Fu, Ping, Kidney Research Institute, Division of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China
Background

The prevalence of sleep apnea (SA) is diverse across preceding studies in chronic kidney disease (CKD) patients.

Methods

A systematic review and meta-analysis was conducted to estimate the aggregated prevalence of SA in adults with non-dialysis CKD. We searched Medline and Embase (up to April 2017) for relevant studies. The pooled prevalence of SA was calculated. Subgroup analyses based on varied means of identifying SA, different stages of CKD and gender were conducted as well. Random-effects model was employed in our meta-analysis.

Results

20 out of 2553 studies involving 2,790 participants were included. The pooled prevalence of SA positive varied between different tools. The prevalence of SA positive screened by sleep rating scales was 25%, while the prevalence of SA diagnosed by sleep monitoring like polysomnography was 54%, which was significantly higher than that in sleep questionnaires subgroup (P for subgroup analysis=0.018; Figure 1). Besides, in studies utilizing polysomnography patients with advanced CKD may have a greater chance of suffering from severe SA (P for subgroup difference=0.082; Figure 2). In addition, subgroup analysis based on gender showed that male participants were more likely to be affected by moderate to severe SA than female participants (50% vs. 29%, P for subgroup difference =0.02: Figure 3).

Conclusion

SA is a common comorbidity in about half of non-dialysis CKD patients. Sleep rating scales underestimates the presence of SA compared with sleep monitoring. The risk of SA increases with the stages of CKD. Moreover, Male CKD patients have a higher risk for SA than female patients. It is necessary to routinely screen SA in non-dialysis CKD patients, and randomized trials using standard diagnostic criteria to identify SA are needed. More studies about effects of interventions against SA on the progression of CKD are required.

Figures for subgroup analyses