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Meta-analysis of the effects of CPAP therapy on estimated glomerular filtration rate in patients with obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Obstructive sleep apnea (OSA) is highly prevalent in patients with chronic kidney disease and may lead to a loss of kidney function. However, it remains unclear whether or not continuous positive airway pressure (CPAP) treatment improves the estimated glomerular filtration rate (eGFR) in patients with OSA. This meta-analysis was designed to investigate the effect of CPAP therapy on eGFR in patients with OSA.

Methods

We searched the electronic databases Web of Science, Cochrane Library, PubMed, and Embase through June 1, 2022. Information about patients, CPAP duration, gender distribution, pre- and post-CPAP treatment eGFR, and age of patients were collected for further analysis. We applied the standardized mean difference (SMD) with a 95%confidence interval (CI) to analyze the pooled effects. Both Stata 12.0 software and Review Manager 5.2 software were employed for all statistical analyses.

Results

A sample of 13 studies with 519 patients was included in the meta-analysis. There was no significant change of eGFR levels before and after CPAP usage for patients with OSA (SMD =  − 0.05, 95%CI: − 0.30 to 0.19, Z = 0.43, p = 0.67). However, subgroup analysis revealed that the level of eGFR was obviously decreased after CPAP therapy in patients with OSA and CPAP use duration > 6 months (SMD =  − 0.30, 95% CI =  − 0.49 to - 0.12, z = 3.20, p = 0.001), and elderly patients (> 60 years) (SMD =  − 0.32, 95% CI =  − 0.52 to − 0.11, z = 3.02, p = 0.002).

Conclusions

Meta-analysis confirmed that OSA treatment with CPAP has no clinically significant effect on eGFR.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The Joint Funds for the innovation of science and Technology, Fujian province (Grant number: 2021Y9027), Science and Technology Bureau of Quanzhou (Grant number: 2022C038R), Young and middle-aged backbone talents training project of Fujian Provincial Health Commission (Grant number: 2021GGA040), Science and Technology Project of Fujian Education Department (Grant number: JAT200136), Startup Fund for Scientific Research, Fujian Medical University (Grant number: 2018QH1105), and the project of Fujian Provincial Health Commission (Grant number: 2019-ZQN-66) provided financial support in the form of financial funding. The sponsor had no role in the design or conduct of this research.

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Author notes

  1. Yuyu Fu and Jiayu Lin contributed equally to the work

Authors and Affiliations

  1. Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, No.950 Donghai Street, Quanzhou, 362000, Fengze District, China

    Yuyu Fu

  2. Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Fujian Medical University, No. 950 Donghai Street, Quanzhou, 362000, Fengze District, China

    Jiayu Lin, Lijun Chen, Xiaoyu Chen & Qingshi Chen

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  1. Yuyu Fu
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All authors directly participated in the study and have reviewed and approved the final manuscript.

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Correspondence to Xiaoyu Chen or Qingshi Chen.

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Fu, Y., Lin, J., Chen, L. et al. Meta-analysis of the effects of CPAP therapy on estimated glomerular filtration rate in patients with obstructive sleep apnea. Sleep Breath 27, 2155–2163 (2023). https://doi.org/10.1007/s11325-023-02811-6

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