Kidney transplantation: a possible solution to obstructive sleep apnea in patients with end-stage kidney disease

Abstract

Introduction: Obstructive sleep apnea (OSA) is frequently reported among patients with chronic kidney disease resulting in considerable morbidity and mortality. OSA may cause repetitive stimulation of the sympathetic nervous system and elevations in pulmonary artery pressure leading to an elevated risk of cardiac and vascular complications in patients with chronic kidney disease. Furthermore, OSA is associated with progressive worsening of kidney injury and loss of renal function. Methods: In this systematic review and meta-analysis, we evaluated the effect of renal transplantation on the progression of OSA in patients with end-stage kidney disease. Results: The meta-analysis included eight studies with a total of 401 patients. Findings showed that kidney transplantation does not lead to a statistically significant effect on the apnea–hypopnea index (MD 2.6 events/hr, 95% CI −3.2 to 8.3, p = 0.21), total sleep time (MD 14.7 min/night, 95% CI −8.4 to 37.8, p = 0.76), sleep efficiency (MD 2.5%, 95% CI −1.4 to 6.3, p = 0.57), slow wave sleep (MD 0.4% of total sleep time, 95% CI −7.5 to 8.4, p = 0.05), and rapid eye movement sleep (MD 0.6% of total sleep time, 95% CI −2.2 to 3.3, p = 0.98). There was no statistically significant effect of kidney transplantation on OSA in patients with chronic renal disease.