Sleep Quality and Sleep Duration with CKD are Associated with Progression to ESKD

Yamamoto, Ryohei; Shinzawa, Maki; Isaka, Yoshitaka; Yamakoshi, Etsuko; Imai, Enyu; Ohashi, Yasuo; Hishida, Akira

doi:10.2215/cjn.01340118

Cited by 73 publications

(57 citation statements)

References 51 publications

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“…In addition, in this study, a significant relationship was found between short (<5 hours) and long sleep time (> 8 hours) with ESRD risk. [27] In our study, we did not find a significant relationship between poor quality of sleep and renal progression states such as ESRD, ESRD+mortality, and e-GFR ≥ 25 ml/min reduction. Shafi ST. et al did not find a significant relationship between GFR reduction and quality of sleep in their study.…”

Section: Discussioncontrasting

confidence: 72%

Kronik Böbrek Hastalığı Olan Hastalarda Kötü Uyku Kalitesiyle İlgili Faktörlerin Böbrek Yetmezliğinin İlerlemesine Etkisi

Erkuş

Güney

2020

Journal of Contemporary Medicine

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In recent years, limited studies have been attempted to characterize the quality of sleep in patients with predialysis chronic renal disease (CKD), and the evidence has shown that insufficient sleep time or poor-quality sleep lead to the progression of CKD. In this study, we aimed to determine the factors related to poor quality of sleep in the patients with CKD and evaluate the effects of these factors on renal progression. Material and Method: Patients with pre-dialysis CKD (E3-E5) over 18 years of age who did not have cardiovascular disease, obstructive sleep apnea, and active infection, started to be followed between June 2015 and November 2015, were included in the study. The quality of sleep these patients was measured using the Pittsburgh quality of sleep index (PSQI). At the end of the 4-year follow-up, the primary outcomes of the patients were accepted as ESRD, ESRD + mortality, and progression (25 ml/min reduction in GFR). Results: Of the 179 patients followed in the study, 107 (59.8%) had good quality of sleep, 72 (40.2%) had poor quality of sleep. In the Binary Logistic Regression analysis performed to detect independent markers of poor quality of sleep; old age and female gender were found to be independent predictors of poor quality of sleep. It was found that poor quality of sleep did not affect renal progression conditions such as ESRD, ESRD + Mortality, and GFR≥ 25 ml/min decrease. Conclusion: As a result, we determined that age and female gender are independent determinants of poor quality of sleep and poor quality of sleep increases mortality.

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Section: Discussioncontrasting

confidence: 72%

Kronik Böbrek Hastalığı Olan Hastalarda Kötü Uyku Kalitesiyle İlgili Faktörlerin Böbrek Yetmezliğinin İlerlemesine Etkisi

Erkuş

Güney

2020

Journal of Contemporary Medicine

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“…Several studies had investigated the association between sleep and kidney health outcome. Both short and long sleep duration were reported to be associated with decreased eGFR and the progression to ESRD among CKD 12, 21, 32, 33 or hypertension 18 population, and to be associated with increased eGFR, hyperfiltration, inadequate hydration and the prevalence of CKD among community-based general population 13, 19, 20, 26–28 . In our study, based on same general community population, we further demonstrated that inappropriate sleep duration had converse effects on eGFR in healthy or early-stage nephropathy population, which was consistent to previous studies.…”

Section: Discussionmentioning

confidence: 99%

Self-reported sleep duration and daytime napping are associated with renal hyperfiltration and microalbuminuria in apparently healthy Chinese population

Zhang

Yan

et al. 2019

Preprint

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The word count of the manuscript and abstract are 3404 and 247. Abstract 2 Background: Sleep duration affects health in various way. The objective of this study 3 was to investigate the relationship between sleep duration, daytime napping and kidney 4 function in a middle-aged apparently healthy Chinese population.5Methods: According to self-reported total sleep and daytime napping duration, 33,850 6 participants aged 38 to 90 years old from 8 regional centers were divided into subgroups. 7 Height, weight, waistline, hipline, blood pressure, biochemical index, FBG, PBG, 8 HbA1c, creatinine and urinary albumin-creatinine ratio (UACR) were measured and 9 recorded in each subject. Microalbuminuria was defined as UACR>=30 mg/g, CKD 10 was defined as eGFR<60 ml/min and hyperfiltration was defined as eGFR>=135 11 ml/min. Multiple logistic regressions were applied to investigate associations between 12 sleep and kidney function. 13Results: Compared to participants with [7-8]h/day sleep, ORs of >9 h/day, (8, 9]h/day 14 and <6h/day sleep for microalbuminuria were 1.317 (1.200-1.446, p<0.001), 1.215 15 (1.123-1.315, p<0.001) and 1.218 (0.967-1.534, p=0.094). eGFR levels were U-shaped 16 associated with sleep duration among subjects with >=90ml/min eGFR, and N-shaped 17 associated with sleep duration among subjects with <90ml/min eGFR. OR of >9h/day 18 sleep for hyperfiltration was 1.400 (1.123-1.745, p=0.003) among eGFR>=90 ml/min 19 participants. Daytime napping had a negative effect on renal health. Compared to 20 participants did not have napping habit, the ORs of (0，1]h/day, (1，1.5]h/day and 21 >1.5h/day daytime napping for microalbuminuria were 1.477 (1.370-1.591, p<0.001), 22 1.217 (1.056, 1.403, p=0.007) and 1.447 (1.242, 1.687, p<0.001). 23 Conclusions: Total sleep duration are U-shaped associated with renal health outcomes. 24 Daytime napping had a negative effect on renal health. 25 42reported inappropriate sleep duration contributes to glomerular hyperfiltration 13,26-28 . 43 This difference in outcomes can be attributed not only to differences in race, age, social 44 work stress, health and economic status of the participants, but also to the fact that in 45 the progression of CKD, healthy individuals tend to have glomerular hyperfiltration 46 initially, followed by increased risk for renal injury, leading to a decrease in filtration 47 Study subjects: A total of 33,850 participants from 8 regional centers include in the 57 REACTION (Risk Evaluation of cAncers in Chinese diabeTic Individuals a 58 LONgitudinal) study, in which are Dalian, Guangzhou, Zhengzhou, Lanzhou, Luzhou, 59 Wuhan, Guangxi, and Shanghai. Excluded participants with primary kidney diseases, 60 daily ACEI/ARB medicine use, and those with a fallacious self-reported sleep duration 61 (<4 h or >12 h).62 Questionnaire: A standardized questionnaire was used to collect basic information 63 including medical history, physical exercise, and smoking and drinking habits. Self-64 reported sleep duration and daytime napping time were ascertained...

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“…Sleep disorders are common among patients with CKD, who experience both poor sleep quality and a lower amount of sleep when compared to the general population [ 43 ]. Indeed, sleep duration has been associated with progression to end-stage renal disease [ 44 ]. However, most studies were confined to dialysis patients and there is scarce information on sleep disorders among CKD patients within the conservative management scenario.…”

Section: Discussionmentioning

confidence: 99%

Design and methodology of the Aging Nephropathy Study (AGNES): a prospective cohort study of elderly patients with chronic kidney disease

et al. 2020

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Background Renal replacement therapy (RRT) is usually indicated for patients with chronic kidney disease (CKD) with glomerular filtration rate below 10 ml/ml/min/1.73m2. However, the need for RRT and timing of dialysis initiation are debatable for patients aged 70 years or older. We here describe the study design and methodology of the Aging Nephropathy Study (AGNES) protocol that aims at evaluating to what extent geriatric-related conditions such as frailty, cognitive dysfunction, and presence of comorbidities have an impact on survival and RRT initiation in this group of patients. In this manuscript we provide detailed information about the AGNES study design and methodology. Methods AGNES is a prospective observational cohort that aim to investigate clinical, biochemical and demographic factors associated with RRT initiation and mortality of patients with CKD stage 4 or 5 who are aged 70 years and older. We plan to include 200 patients over 5 years. Clinically stable outpatients on conservative management for at least 6 months will be recruited from the Nephrogeriatric Clinic at the Hospital das Clinicas da Universidade de Sao Paulo, Brazil. Eligible patients are submitted to a full clinical examination, geriatric assessment, and blood test at baseline. Following the baseline visit the patients are being monitored during an observational follow up period of at least 12 months during which patients will be contacted in the clinic at their regular follow up or by phone until either RRT initiation or death occurs. This cohort includes evaluation of cognition by the education-adjusted 10-point Cognitive Screener (10-CS), frailty by Fried index score, a complete nutritional assessment (by body composition assessment, global subjective assessment and dietary intake), comorbidities by Charlson comorbidity index and biochemical markers including FGF-23 and Klotho. Discussion The AGNES cohort, a real-world study of current clinical practice in elderly patients with advanced CKD prior to dialysis initiation, will shed light into progression of CKD and its complications, indications of RRT and factors determining survival. This investigation will elucidate to what extent geriatric conditions, nutritional status and clinical factors are associated with survival, quality of life and RRT initiation in elderly CKD patients not yet on dialysis. Trial registration Registered on ClinicalTrials.gov on 18 October 2019 (NCT04132492).

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Sleep Quality and Sleep Duration with CKD are Associated with Progression to ESKD

Cited by 73 publications

References 51 publications

Kronik Böbrek Hastalığı Olan Hastalarda Kötü Uyku Kalitesiyle İlgili Faktörlerin Böbrek Yetmezliğinin İlerlemesine Etkisi

Kronik Böbrek Hastalığı Olan Hastalarda Kötü Uyku Kalitesiyle İlgili Faktörlerin Böbrek Yetmezliğinin İlerlemesine Etkisi

Self-reported sleep duration and daytime napping are associated with renal hyperfiltration and microalbuminuria in apparently healthy Chinese population

Design and methodology of the Aging Nephropathy Study (AGNES): a prospective cohort study of elderly patients with chronic kidney disease

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