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Koh JH, Yeo BSY, Tan TWE, See MYS, Ng ACW, Loh SRH, Gooley J, Tan CS, Toh ST. The association of sleep duration with the risk of chronic kidney disease: a systematic review and meta-analysis. Clin Kidney J 2024; 17:sfae177. [PMID: 39114497 PMCID: PMC11304598 DOI: 10.1093/ckj/sfae177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Indexed: 08/10/2024] Open
Abstract
Background and hypothesis Published literature suggests that sleep duration and quality may be affected in adults with chronic kidney disease. However, the relationship between these two entities remains a matter of debate. The objective of this systematic review and meta-analysis is to assess the effect of sleep duration and quality on chronic kidney disease. Methods A systematic review of the Medline/PubMed, Embase, Cochrane Library, and CINAHL databases was conducted for articles pertaining to the association between sleep duration and quality on chronic kidney disease. The main outcome was the hazard/risk ratio of chronic kidney disease in patients of varying sleep durations and quality. Results In total, 42 studies (2 613 971 patients) with a mean age of 43.55 ± 14.01 years were included in the meta-analysis. Compared with a reference range of 7 to 8 hours of sleep, short sleep durations of ≤4 hours (RR 1.41, 95% CI: 1.16 to 1.71, P < 0.01), ≤5 hours (RR 1.46, 95% CI: 1.22 to 1.76, P < 0.01), ≤6 hours (RR 1.18, 95% CI: 1.09 to 1.29, P < 0.01), and ≤7 hours (RR 1.19, 95% CI: 1.12 to 1.28, P < 0.01) were significantly associated with an increased risk of incident chronic kidney disease. Long sleep durations of ≥8 hours (RR 1.15, 95% CI: 1.03 to 1.28, P < 0.01) and ≥9 hours (RR 1.46, 95% CI: 1.28 to 1.68, P < 0.01) were also significantly associated with an increased risk of incident chronic kidney disease. Meta-regression did not find any significant effect of age, gender, geographical region, and BMI and an association with sleep duration and risk of incident chronic kidney disease. Conclusion Both short and long sleep durations were significantly associated with a higher risk of chronic kidney disease. Interventions targeted toward achieving an optimal duration of sleep may reduce the risk of incident chronic kidney disease.
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Affiliation(s)
- Jin Hean Koh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Brian Sheng Yep Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Timothy Wei En Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mark Yong Siang See
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Adele Chin Wei Ng
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore, Singapore
| | - Shaun Ray Han Loh
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore, Singapore
- Singhealth Duke-NUS Sleep Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Joshua Gooley
- Singhealth Duke-NUS Sleep Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Chieh Suai Tan
- Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore
| | - Song Tar Toh
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore, Singapore
- Singhealth Duke-NUS Sleep Centre, Duke-NUS Medical School, Singapore, Singapore
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Hannan M, Jeamjitvibool T, Luo Q, Izci-Balserak B, Ajilore O, Lash JP, Zhou XJ, Bronas UG. The Relationship Between Sleep and Brain Function in Older Adults With Chronic Kidney Disease and Self-Identified Cognitive Impairment. J Gerontol Nurs 2023; 49:31-39. [PMID: 37379049 PMCID: PMC10393368 DOI: 10.3928/00989134-20230616-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Older adults with chronic kidney disease (CKD) are at risk for cognitive impairment and sleep disturbances. The purpose of the current study was to investigate the relationship between sleep and brain structure/function in older adults with CKD and self-identified cognitive impairment. The sample (N = 37) had a mean age of 68 years (SD = 4.9 years), estimated glomerular filtration rate of 43.7 mL/min/1.73m2 (SD = 10.98), median sleep time of 7.4 hours, and was 70% female. Sleeping <7.4 hours, compared to ≥7.4 hours, was associated with better attention/information processing (β = 11.46, 95% confidence interval [CI] [3.85, 19.06]) and better learning/memory (β = 2.06, 95% CI [0.37, 3.75]). Better sleep efficiency was associated with better global cerebral blood flow (β = 3.30, 95% CI [0.65, 5.95]). Longer awake length after sleep onset was associated with worse fractional anisotropy of the cingulum (β = -0.01, 95% CI [-0.02, -0.003]). Sleep duration and continuity may be related to brain function in older adults with CKD and self-identified cognitive impairment. [Journal of Gerontological Nursing, 49(7), 31-39.].
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Affiliation(s)
- Mary Hannan
- College of Nursing, University of Illinois Chicago, Chicago, IL
| | - Thanakrit Jeamjitvibool
- College of Nursing, University of Illinois Chicago, Chicago, IL
- Princess Agrarajakumari College of Nursing, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Qingfei Luo
- Center for Magnetic Resonance Research, College of Medicine, University of Illinois Chicago, Chicago, IL
| | | | - Olu Ajilore
- College of Medicine, University of Illinois Chicago, Chicago, IL
| | - James P. Lash
- College of Medicine, University of Illinois Chicago, Chicago, IL
| | - Xiaohong Joe Zhou
- Center for Magnetic Resonance Research, College of Medicine, University of Illinois Chicago, Chicago, IL
- Department of Radiology, College of Medicine, University of Illinois Chicago, Chicago, IL
| | - Ulf G. Bronas
- College of Nursing, University of Illinois Chicago, Chicago, IL
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Wei CS, Yan CY, Yu XR, Wang L, Zhang R, Jiang JY, Dai Q, Li JR, Chen XM. Association Between White Matter Hyperintensities and Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:770184. [PMID: 35592851 PMCID: PMC9112853 DOI: 10.3389/fmed.2022.770184] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Previous studies of the associations between white matter hyperintensities (WMH) and chronic kidney disease (CKD) were still conflicting; therefore, our study aimed to conduct a systematic review of all of the available research on this topic and a meta-analysis of the association between WMH and CKD among observational studies. Setting and Design Systematic review and meta-analysis. Outcome Measures Severity of WMH. Methods and Participants All relevant studies in public databases were examined until 15 November 2020. Two independent reviewers assessed all the included studies using the Cross-Sectional/Prevalence Study Quality (CSSQ) scale, and then literature review and meta-analyses were undertaken. Results We pooled the odds ratio (OR) for the presence of WMH, periventricular hyperintensities (PVH), and deep subcortical white matter hyperintensities (DWMH) of patients with CKD vs. non-CKD patients by subgroup analysis, and the results obtained were WMH OR 2.07, 95% CI [1.58, 2.70], PVH OR 2.41, 95% CI [1.90, 3.05], and DWMH OR 2.11, 95% CI [1.60, 2.80], respectively. The main outcome showed that patients with CKD were more likely to have WMH in the brain compared to the normal controls. Another meta-analysis showed a statistically significant decline in renal function in patients with moderate to severe WMH compared with those with no to mild WMH. Conclusions The findings indicated that patients with CKD were more likely to experience WMH than demographically matched controls. On the other hand, patients with moderate to severe WMH in the brain had poor renal function more frequently than those with no to mild WMH.
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Affiliation(s)
- Cun-Sheng Wei
- Department of Neurology, The Affiliated Jiangning Hospital With Nanjing Medical University, Nanjing, China
| | - Cai-Yun Yan
- Department of Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Rong Yu
- Department of Neurology, The Affiliated Jiangning Hospital With Nanjing Medical University, Nanjing, China
| | - Lin Wang
- Department of Neurology, The Affiliated Jiangning Hospital With Nanjing Medical University, Nanjing, China
| | - Rui Zhang
- Department of Neurology, The Affiliated Jiangning Hospital With Nanjing Medical University, Nanjing, China
| | - Jun-Ying Jiang
- Department of Neurology, The Affiliated Jiangning Hospital With Nanjing Medical University, Nanjing, China
| | - Qi Dai
- Department of Neurology, The Affiliated Jiangning Hospital With Nanjing Medical University, Nanjing, China
| | - Jun-Rong Li
- Department of Neurology, The Affiliated Jiangning Hospital With Nanjing Medical University, Nanjing, China
| | - Xue Mei Chen
- Department of Neurology, The Affiliated Jiangning Hospital With Nanjing Medical University, Nanjing, China
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4
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Bai Y, Zhang L, Liu C, Cui X, Li D, Yin H. Association of white matter volume with sleep quality: a voxel-based morphometry study. Brain Imaging Behav 2021; 16:1163-1175. [PMID: 34846693 DOI: 10.1007/s11682-021-00569-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2021] [Indexed: 01/13/2023]
Abstract
Many studies have focused on the gray matter volume associated with sleep quality, little is known about the relationship between white matter volume and sleep quality. Brain white structure is a crucial component in the structural neuroanatomy. Therefore, in this study, we investigated the association between white matter volume and sleep quality. Data were collected using the Pittsburgh Sleep Quality Index and voxel-based morphometry among 352 college students. Results showed that the global PSQI score was negatively associated with the white matter volume, including in the right middle occipital gyrus, the left superior temporal gyrus, the right the precentral gyrus, the left supramarginal gyrus, the left middle frontal gyrus, the left precunes, and the right superior frontal gyrus. Results also indicated that the white matter volume in specific regions negatively associated with the factor of PSQI. These specific brain regions may be replicated in brain areas related to sleep quality. In summary, we suggested that exploring brain white structure are related to sleep could help to expound the mechanisms by which sleep quality are associated with brain function, behavior and cognition, as well as potentially the networks and systems responsible for variations in sleep themselves.
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Affiliation(s)
- Youling Bai
- School of Education Science, Hunan Normal University, Changsha, 410081, China.,Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, 410081, China
| | - Li Zhang
- School of Education Science, Hunan Normal University, Changsha, 410081, China.,Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, 410081, China
| | - Chengwei Liu
- Department of Psychology, Hunan University of Science and Technology, Xiangtan, 411201, China
| | - Xiaobing Cui
- School of Education Science, Hunan Normal University, Changsha, 410081, China.,Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, 410081, China
| | - Dan Li
- School of Education Science, Hunan Normal University, Changsha, 410081, China. .,Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, 410081, China.
| | - Huazhan Yin
- School of Education Science, Hunan Normal University, Changsha, 410081, China. .,Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, 410081, China.
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Cardiometabolic determinants of early and advanced brain alterations: Insights from conventional and novel MRI techniques. Neurosci Biobehav Rev 2020; 115:308-320. [DOI: 10.1016/j.neubiorev.2020.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/21/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
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6
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Kocevska D, Cremers LGM, Lysen TS, Luik AI, Ikram MA, Vernooij MW, Tiemeier H. Sleep complaints and cerebral white matter: A prospective bidirectional study. J Psychiatr Res 2019; 112:77-82. [PMID: 30861469 DOI: 10.1016/j.jpsychires.2019.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 02/05/2019] [Accepted: 02/07/2019] [Indexed: 12/01/2022]
Abstract
Sleep complaints and brain changes co-occur in older adulthood, but the temporal relation between these processes is poorly understood. Poor sleep may destabilize axonal integrity and deteriorate white matter, but white matter pathology can also precede sleep complaints. Our objective was to explore a prospective, possibly bi-directional association between subjective sleep complaints and micro- and macro-structural properties of cerebral white matter. We assessed sleep complaints and brain magnetic resonance imaging at two time-points (2006-2008 and 2011-2014) in a population-based cohort including 2529 participants (56 ± 6 years old, 55% women). Sleep complaints were assessed with the Pittsburgh Sleep Quality Index. White matter lesion (WML) volume was assessed from fluid-attenuated inversion recovery images and global and tract-specific white matter microstructural integrity with diffusion tensor imaging. Sleep complaints at baseline were not associated with changes in WML volume or global white matter microstructure. In tract-specific analyses, however, sleep complaints were associated with reduced microstructural integrity in two white matter tracts projecting to the brainstem, but only when uncorrected for multiple testing. Likewise, we found no evidence for the reverse association; micro- or macro-structural properties of white matter were not related to changes in sleep complaints over time. This study provides evidence against the hypothesis that sleep complaints lead to white matter changes in the aging brain, and shows that white matter properties do not underlie sleep complaints in older persons. As subjective sleep complaints increase in later life, it is important to demonstrate that these are not etiologically related to cerebral white matter pathology.
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Affiliation(s)
- Desana Kocevska
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Lotte G M Cremers
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Thom S Lysen
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, USA.
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7
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Reasons for Declining Consent in a Population-Based Cohort Study Conducted in a Rural South American Community. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2018; 2018:8267948. [PMID: 30598669 PMCID: PMC6287151 DOI: 10.1155/2018/8267948] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/06/2018] [Indexed: 12/11/2022]
Abstract
There is limited information on participants' adherence and reasons for declining consent in observational cohort studies conducted in remote rural communities. We aimed at sharing lessons learned during the Atahualpa Project, a population-based cohort study conducted in a rural Ecuadorian village. Atahualpa residents aged ≥40 years identified during door-to-door surveys who signed a consent form were enrolled. Annual surveys were conducted to assess the number of participants who moved out of the village, as well as those who died, declined consent, and newly entered the study. Reasons for declining consent were tabulated. Abstracted data included age, sex, education, disability, time between enrollment and declining consent, and reasons for withdrawal. We also counted participants who, despite expressing their willingness to continue in the study, refused specific procedures. After five years of follow-up, 54 (6.3%) of 863 enrolled individuals declined consent. Increasing age and disability had no impact on declining consent. In contrast, refusal was higher among relatives or neighbors of a given participant declining consent. Most people who declined consent did so after one or two years of enrollment. Less than 20% of enrolled individuals refused certain procedures. "Fear of the needle" was the most frequent reason for refusing blood tests, and common reasons for declining complimentary exams were lack of interest and time constraints. Cohort retention in the Atahualpa Project is high. Main reasons for this adherence include adequate selection of the village, detailed planning of procedures, assurance of sponsorship, and field personnel who continuously engage with study participants. This trial is registered with NCT01627600.
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Del Brutto OH, Mera RM, Peñaherrera R, Peñaherrera E, Zambrano M, Costa AF. Arterial stiffness and total cerebral small vessel disease score in community-dwelling older adults: Results from the Atahualpa Project. Vasc Med 2018; 24:6-11. [PMID: 30426888 DOI: 10.1177/1358863x18806583] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Information on the association between arterial stiffness and cerebral small vessel disease (cSVD) is limited and confined to white and Asian populations. More regional information is needed to confirm this association in different ethnic groups. Using the Atahualpa Project cohort, we aimed to assess whether the aortic pulse wave velocity (PWV) is associated with the total cSVD score, as well as with each of the neuroimaging signatures of cSVD, in a population of Amerindians living in rural Ecuador. Atahualpa residents aged ⩾ 60 years were offered a brain magnetic resonance imaging scan (MRI) and aortic PWV determination. An ordinal logistic regression model, adjusted for demographics and cardiovascular risk factors, was constructed to predict the total cSVD score by levels of aortic PWV. The association between the neuroimaging signatures of cSVD and the aortic PWV was assessed by adjusted logistic regression models. Of 437 candidates, 303 (69%) underwent a brain MRI and aortic PWV determinations. The total cSVD score was 0 points in 65% of individuals, 1 point in 18%, 2 points in 11%, and 3-4 points in 6%. The mean aortic PWV was 10.4 ± 1.8 m/s, which increased from 9.8 ± 1.2 to 12.3 ± 1.8 m/s in individuals with a cSVD score of 0 and 3-4, respectively ( p < 0.001). An ordinal logistic regression model showed significant association between the PWV and the cSVD score. A change of one unit of the aortic PWV increased the odds of having a higher total cSVD score by 1.73 (95% CI: 1.28-2.35; p < 0.001). In addition, individual neuroimaging signatures of cSVD, with the exception of lacunar infarcts, were associated with the aortic PWV. This study shows a significant association between the aortic PWV and total cSVD score and most of its individual components in older Amerindians.
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Affiliation(s)
- Oscar H Del Brutto
- 1 School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador
| | | | - Rubén Peñaherrera
- 1 School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador
| | | | | | - Aldo F Costa
- 1 School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador
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