Prevalence of sleep apnoea in non-dialysis chronic kidney disease patients: A systematic review and meta-analysis.

Abstract

The prevalence of sleep apnoea (SA) in chronic kidney disease (CKD) varies greatly across preceding studies. The aim of our study was to provide a summary of the prevalence of SA among non-dialysis CKD patients. Medline, Embase, Web of Science, China Knowledge Resource Integrated Database, VIP Chinese scientific journal database (VIP) and Wanfang Digital Periodical Full-text database were searched up to September 2018 to identify publications related to the prevalence of SA in non-dialysis CKD patients assessed by sleep questionnaires or sleep respiration monitoring. Random-effects meta-analysis was used to estimate pooled prevalence of SA. And subgroup analysis and meta-regression were conducted as well. The pooled prevalence of SA in the included 26 studies was 38% (95% confidence interval [CI], 21-70%). In subgroup analyses, the pooled prevalence of SA varied using different diagnostic tools. The pooled prevalence of questionnaire-based SA for CKD was 10% (95% CI, 3-27%), while the prevalence of sleep monitoring-based SA was 56% (95% CI, 49-66%). Also, advanced CKD patients had a greater chance to suffer from moderate-to-severe SA than early stage CKD patients. Male patients were more likely to be affected by moderate-to-severe SA than female patients (47% vs 30%, P = 0.018). Sleep apnoea is commonly seen in both early and advanced non-dialysis CKD patients. Sleep related scales provided lower prevalence than instrumental sleep monitoring, therefore, underestimated the presence of SA. The prevalence of SA increases in advanced CKD. And male patients are more likely to be affected by SA than female patients.