Sleep disorder and chronic kidney disease may have Bidirectional association, unravels study

A new meta-analysis published in the recent issue of Clinical Kidney Journal revealed a significant bidirectional relationship between chronic kidney disease (CKD) and various sleep disorders, including obstructive sleep apnea (OSA), restless leg syndrome (RLS), and insomnia. The study utilized data from over 26 million patients on the interplay between these health conditions and highlighted the potential for targeted interventions to improve patient outcomes. By addressing sleep disorders, physicians may reduce the progression of CKD and improve the quality of life for the ones affected.

This research reviewed 63 observational studies following a systematic protocol registered on PROSPERO. After analyzing data from major medical databases like Medline/PubMed, Embase, Cochrane Library, and CINAHL. The risk ratios (RRs) were calculated to quantify the associations between CKD and sleep disorders.

The outcomes of this study found that obstructive sleep apnea (OSA) was significantly linked to CKD, with a 68% higher risk for CKD development among individuals with OSA (RR 1.68; 95% CI 1.45–1.93). The patients with CKD underwent a 60% higher risk of developing OSA (RR 1.60; 95% CI 1.35–1.89).

Other sleep disorders like RLS and insomnia also demonstrated critical associations. RLS was associated with an 88% higher risk of CKD (RR 1.88; 95% CI 1.48–2.38), and insomnia raised CKD risk by 24% (RR 1.24; 95% CI 1.01–1.54). Also, individuals with CKD had increased risks of RLS (RR 1.73; 95% CI 1.32–2.25) and insomnia (RR 1.14; 95% CI 1.03–1.27). The markers of kidney damage like albuminuria, were significantly associated with OSA (RR 1.54; 95% CI 1.18–1.99).

The study brings out a consistent bidirectional relationship across different CKD stages, diagnostic methods, and geographical regions. This suggests that managing one condition can positively influence the other. For instance, treating sleep disorders like OSA may slow CKD progression or reduce its severity, while early CKD management might mitigate the risk of sleep disturbances.

These findings advocate for integrated care approaches. Clinicians could substantially reduce associated health risks by screening for and addressing sleep disorders in CKD patients. Early identification and treatment of CKD in patients with OSA, RLS, or insomnia may also prove beneficial. Overall, this research highlights the importance of customized care strategies that account for the complex interaction between kidney health and sleep quality.

Source:

Koh, J. H., Lim, C. Y. J., Yam, K. J. M., Yeo, B. S. Y., Ng, A. C. W., Loh, S. R. H., Hsu, P. P., Gooley, J., Tan, C. S., & Toh, S. T. (2024). Bidirectional association of sleep disorders with chronic kidney disease: a systematic review and meta-analysis. In Clinical Kidney Journal (Vol. 17, Issue 11). Oxford University Press (OUP). https://doi.org/10.1093/ckj/sfae279