Exploring Bidirectional Causality between Obstructive Sleep Apnea and Chronic Kidney Disease via Mendelian...

Area of Science:

• Nephrology
• Pulmonology
• Genetics

Background:

• Obstructive sleep apnea (OSA) and chronic kidney disease (CKD) are prevalent conditions with potential shared risk factors.
• The causal relationship between OSA and CKD, as well as its impact on renal function, remains incompletely understood.

Purpose of the Study:

• To investigate the bidirectional causal associations between obstructive sleep apnea (OSA) and chronic kidney disease (CKD).
• To explore the causal links between OSA and key markers of renal function, including eGFRcrea, eGFRcys, UACR, and BUN.

Main Methods:

• A two-sample bidirectional Mendelian randomization (MR) approach was employed.
• Genetic variants were used as instrumental variables to assess causal effects between OSA and renal parameters.
• Multiple MR methods, including IVW and MR-Egger, were utilized, with sensitivity analyses performed to ensure robustness.

Main Results:

• Genetically predicted OSA showed a significant association with increased blood urea nitrogen (BUN) but not with CKD, eGFRcrea, eGFRcys, or UACR.
• Conversely, genetically predicted cystatin C-based estimated glomerular filtration rate (eGFRcys) and BUN were associated with an increased risk of OSA.
• Sensitivity analyses indicated no significant genetic pleiotropy, and results were consistent across different MR methods.

Conclusions:

• Mendelian randomization analysis suggests a potential causal role for kidney function in the development of OSA.
• The direct causal relationship between OSA and CKD, or its impact on renal function, remains uncertain.
• Further research is warranted to elucidate the complex interplay between OSA and chronic kidney disease.