The association of obstructive sleep apnea and renal outcomes-a systematic review and meta-analysis

Background: The aim of this systematic review and meta-analysis was to summarize the association of obstructive sleep apnea (OSA) with renal outcome. Methods: Our study followed the PRISMA guidelines. Two independent reviewers searched for relevant articles in the databases of Pubmed, the Web of Science and CENTRAL, and conducted study selection and quality assessment. A random-effect model was used to estimate the effects. Results: A total of 1240 articles were initially identified (Pubmed = 568, Web of Science = 640, CENTRAL = 32). After removal of duplicate articles (n = 415) and irrelevant articles (n = 788), 37 were selected for full-text review, and 18 were finally included in the analysis. Overall, patients diagnosed with OSA were found to have a higher odds ratio (OR) of a poorer renal outcome, with a pooled OR of 1.77 (95% C.I.: 1.37-2.29). The significant association between OSA and a poorer renal outcome was not affected by the medical condition of diabetes mellitus (DM). In addition, we found that OSA was consistently associated with higher albuminuria/proteinuria and a lower estimated glomerular filtration rate (eGFR), with a pooled OR of 1.84 (95% C.I.: 1.24-2.73) and 1.60 (95% C.I.: 1.19-2.16), respectively. A greater OSA severity was also found to be related to a higher OR, with a mild group OR of 1.45 (95% C.I.: 1.19-1.77) and a moderate and severe group OR of 2.39 (95% C.I.: 1.96-2.90). Conclusions: Our study demonstrated that OSA is significantly associated with poorer renal function.