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. 2023 Nov 14;17(1):sfad179.
doi: 10.1093/ckj/sfad179. eCollection 2024 Jan.

Sleep apnoea syndrome prevalence in chronic kidney disease and end-stage kidney disease patients: a systematic review and meta-analysis

Anna Pisano  1 , Carmine Zoccali  2   3   4 , Davide Bolignano  5 , Graziella D'Arrigo  1 , Francesca Mallamaci  1   6
Affiliations

Sleep apnoea syndrome prevalence in chronic kidney disease and end-stage kidney disease patients: a systematic review and meta-analysis

Anna Pisano et al. Clin Kidney J. .

Abstract

Background: Several studies have examined the frequency of sleep apnoea (SA) in patients with chronic kidney disease (CKD), reporting different prevalence rates. Our systematic review and meta-analysis aimed to define the clinical penetrance of SA in CKD and end-stage kidney disease (ESKD) patients.

Methods: Ovid-MEDLINE and PubMed databases were explored up to 5 June 2023 to identify studies providing SA prevalence in CKD and ESKD patients assessed by different diagnostic methods, either sleep questionnaires or respiration monitoring equipment [such as polysomnography (PSG), type III portable monitors or other diagnostic tools]. Single-study data were pooled using the random-effects model. The Chi2 and Cochrane-I2 tests were used to assess the presence of heterogeneity, which was explored performing sensitivity and/or subgroup analyses.

Results: A cumulative analysis from 32 single-study data revealed a prevalence of SA of 57% [95% confidence interval (CI) 42%-71%] in the CKD population, whereas a prevalence of 49% (95% CI 47%-52%) was found pooling data from 91 studies in ESKD individuals. The prevalence of SA using instrumental sleep monitoring devices, including classical PSG and type III portable sleep monitors, was 62% (95% CI 52%-72%) and 56% (95% CI 42%-69%) in CKD and ESKD populations, respectively. Sleep questionnaires revealed a prevalence of 33% (95% CI 16%-49%) and 39% (95% CI 30%-49%).

Conclusions: SA is commonly seen in both non-dialysis CKD and ESKD patients. Sleep-related questionnaires underestimated the presence of SA in this population. This emphasizes the need to use objective diagnostic tools to identify such a syndrome in kidney disease.

Keywords: chronic kidney disease; end-stage kidney disease; meta-analysis; sleep apnoea; systematic review.

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Conflict of interest statement

C.Z. and F.M. are members of the CKJ editorial board. The results presented in this article have not been published previously in whole or part. Authors declare no conflicts of interest related to the present work.

Figures

Figure 1:
Figure 1:
Study selection flow.
Figure 2:
Figure 2:
Pooled prevalence of SA in CKD according to different diagnostic criteria.
Figure 3:
Figure 3:
(a) Pooled prevalence of SA in ESKD according to instrumental monitoring devices. (b) Pooled prevalence of SA in ESKD according to sleep questionnaires.
See this image and copyright information in PMC

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