OBSTRUCTIVE SLEEP APNEA, PHYSICAL ACTIVITY, AND RISK OF INCIDENT CHRONIC KIDNEY DISEASE: A PROSPECTIVE COHORT STUDY FROM THE UK BIOBANK
Author(s)
Xuanbi Fang1, Wai-kit Ming, MBA, MPH, PhD, MD2.
1Hong Kong, China, 2City University of Hong Kong, City University of Hong Kong, China.
1Hong Kong, China, 2City University of Hong Kong, City University of Hong Kong, China.
OBJECTIVES: To examine the prospective association between obstructive sleep apnea (OSA) and incident chronic kidney disease (CKD), and to assess whether moderate-to-vigorous physical activity (MVPA) is related to CKD risk by OSA status.
METHODS: This prospective cohort study included 302,050 participants from the UK Biobank who were free of CKD at baseline. OSA was defined using diagnostic records and self-reported habitual snoring. Incident CKD was identified through linked health records. Participants were followed until CKD diagnosis, death, or 31 May 2023. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for sociodemographic, lifestyle, and clinical factors. Restricted cubic spline analyses examined MVPA-CKD associations by OSA status.
RESULTS: Among 302,050 participants, 5,407 had OSA and 296,643 did not. During follow-up of up to 17.2 years, 16,792 participants developed CKD, including 459 cases among individuals with OSA and 16,333 cases among those without OSA. The cumulative incidence of CKD was higher in participants with OSA than in those without OSA (8.49% vs. 5.51%). In the unadjusted model, OSA was associated with a significantly increased risk of CKD (HR = 1.58, 95% CI: 1.44-1.73). The association remained significant after adjustment for age, sex, and ethnicity (HR = 1.44, 95% CI: 1.31-1.58), and after further adjustment for socioeconomic and lifestyle factors (HR = 1.31, 95% CI: 1.19-1.43). In the fully adjusted model, OSA remained independently associated with a higher risk of incident CKD (HR = 1.19, 95% CI: 1.09-1.31). Restricted cubic spline analyses suggested a dose-response relationship between MVPA and CKD risk, indicating that higher levels of physical activity were associated with a progressively lower risk of CKD.
CONCLUSIONS: OSA was independently associated with higher CKD risk. Greater physical activity was associated with lower CKD risk, suggesting MVPA may be a modifiable factor to reduce CKD risk, particularly among individuals with OSA.
METHODS: This prospective cohort study included 302,050 participants from the UK Biobank who were free of CKD at baseline. OSA was defined using diagnostic records and self-reported habitual snoring. Incident CKD was identified through linked health records. Participants were followed until CKD diagnosis, death, or 31 May 2023. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for sociodemographic, lifestyle, and clinical factors. Restricted cubic spline analyses examined MVPA-CKD associations by OSA status.
RESULTS: Among 302,050 participants, 5,407 had OSA and 296,643 did not. During follow-up of up to 17.2 years, 16,792 participants developed CKD, including 459 cases among individuals with OSA and 16,333 cases among those without OSA. The cumulative incidence of CKD was higher in participants with OSA than in those without OSA (8.49% vs. 5.51%). In the unadjusted model, OSA was associated with a significantly increased risk of CKD (HR = 1.58, 95% CI: 1.44-1.73). The association remained significant after adjustment for age, sex, and ethnicity (HR = 1.44, 95% CI: 1.31-1.58), and after further adjustment for socioeconomic and lifestyle factors (HR = 1.31, 95% CI: 1.19-1.43). In the fully adjusted model, OSA remained independently associated with a higher risk of incident CKD (HR = 1.19, 95% CI: 1.09-1.31). Restricted cubic spline analyses suggested a dose-response relationship between MVPA and CKD risk, indicating that higher levels of physical activity were associated with a progressively lower risk of CKD.
CONCLUSIONS: OSA was independently associated with higher CKD risk. Greater physical activity was associated with lower CKD risk, suggesting MVPA may be a modifiable factor to reduce CKD risk, particularly among individuals with OSA.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH212
Topic
Clinical Outcomes, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas