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Peng N, Li S. Short or long sleep duration was associated with chronic kidney disease in a Chinese nationwide cohort study. Int Urol Nephrol 2024; 56:1695-1701. [PMID: 37934349 DOI: 10.1007/s11255-023-03861-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE Sleep duration is an important factor influencing health outcomes. The association between sleep duration and kidney function remains elusive. This study aimed to explore the association between sleep duration and chronic kidney disease (CKD) amongst Chinese adults. METHODS We conducted a cross-sectional study based on the China Health and Nutrition Survey (CHNS) in the wave of 2009. Participants were divided into three groups: ≤ 6 h/day (short sleepers), 7-8 h/day (regular sleepers) and ≥ 9 h/day (long sleepers) according to self-reported sleep duration. CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2. RESULTS A total of 8096 Chinese adults (45.9% men) with a mean age of 50.6 years were included in the study. Compared with regular sleepers, both short and long regular sleepers had a higher prevalence of CKD. A U-shaped relationship between sleep duration and CKD was displayed by restricted cubic spline curve (P-overall < 0.001, P-nonlinear < 0.001). Multivariate logistic regression models revealed that both short and long sleep duration were clinically associated with higher odds of CKD, after adjustments for covariates [adjusted odds ratio (OR) 1.25 and 1.30; 95% confidence interval (CI) 1.00-1.56 and 1.08-1.54, for short and long sleep duration, respectively]. In subgroup analyses, we found the association was still observed in participants without hypertension or diabetes mellitus. CONCLUSION Short or long sleep duration was associated with CKD in the general population.
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Affiliation(s)
- Naling Peng
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Shizhen Li
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
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2
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Wu CC, Yang PL, Kao LT, Liu YC, Zheng CM, Chu P, Lu K, Chu CM, Chang YT. Sleep Duration and Kidney Function - Does Weekend Sleep Matter? Nat Sci Sleep 2024; 16:85-97. [PMID: 38333420 PMCID: PMC10850764 DOI: 10.2147/nss.s427687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/21/2023] [Indexed: 02/10/2024] Open
Abstract
Objective Weekend sleep duration is linked to health issues, including mortality. However, how weekend sleep duration can impact chronic kidney disease (CKD) still needs to be understood. Therefore, we aimed to analyze how weekend sleep duration is associated with kidney function. Methods This is a cross-sectional study. Data were obtained from the 2017-2018 National Health and Nutrition Examination Survey. We included 5362 study participants and categorized them into nine subgroups by sleep duration (short: ≤6 hours, normal: 6-9 hours, and long: ≥9 hours) on weekdays and weekends and analyzed for the respective association with renal function using stratified multivariable linear regression. Results Weekend sleep duration for 9 hours or more was associated with decreasing estimated glomerular filtration rate (eGFR) levels by 2.8 to 6.4 mL/min/1.73 m2 among people with long to short weekday sleep duration compared with short weekday and weekend sleep durations (control group) after adjusting for demographic characteristics, body measurement, sleep quality, smoking, and comorbidities. The study population with short weekday sleep duration (sWK) and long weekend sleep duration (lWD) had the most significant decline in eGFR. For the study population with sWK, eGFR level significantly decreased by 1.1 mL/min/1.73 m2 as sleep duration on weekends increased by one hour. Conclusion The underlying mediators of lWD and CKD could be the dysregulation of human behaviors, metabolism, or biological functions. Longer weekend sleep duration was linked to a decrease in eGFR levels. It warrants further study to clarify the mediators.
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Affiliation(s)
- Chia-Chao Wu
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department and Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan
| | - Pei-Lin Yang
- School of Nursing, National Defense Medical Center, Taipei City, Taiwan
| | - Li-Ting Kao
- School of Pharmacy, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan
| | - Yi-Chun Liu
- School of Public Health, National Defense Medical Center, Taipei City, Taiwan
- Institute of Medical Sciences, National Defense Medical Center, Taipei City, Taiwan
| | - Cai-Mei Zheng
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Pauling Chu
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kuo‐Cheng Lu
- Division of Nephrology, Fu-Jen Catholic Hospital, Fu-Jen Catholic University, Taipei, Taiwan
| | - Chi-Ming Chu
- School of Public Health, National Defense Medical Center, Taipei City, Taiwan
- Department of Surgery, Songshan Branch of Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
- Division of Biostatistics and Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Public Health, China Medical University, Taichung City, Taiwan
| | - Yu-Tien Chang
- School of Public Health, National Defense Medical Center, Taipei City, Taiwan
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Topal M, Erkus E. Improving sleep quality is essential for enhancing soluble Klotho levels in hemodialysis patients. Int Urol Nephrol 2023; 55:3275-3280. [PMID: 37382769 DOI: 10.1007/s11255-023-03693-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/22/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE Sleep and Klotho seem to share common physiological pathways in aging. However, studies investigating this relationship are very few and none of them was done with a specific patient group. The aim of this study was to investigate the association of sleep quality and soluble Klotho levels in hemodialysis patients. METHODS 100 hemodialysis patients were included in this study. Soluble Klotho levels were obtained from each patient and Pittsburgh Sleep Quality Index was performed by all patients. Association of soluble Klotho with sleep quality was calculated. RESULTS Soluble Klotho levels were significantly inversely correlated with total sleep quality score (p < 0.001, r = - 0.444). Among the subscales, soluble Klotho levels were negatively correlated with subjective sleep quality (p < 0.001, r = - 0.365), sleep latency (p = 0.002, r = - 0.312), sleep disturbance (p = 0.002, r = - 0.303) and daytime dysfunction (p = 0.027, r = - 0.221). Patients who had good sleep quality scores were found to have higher soluble Klotho levels [4.15 (0.05-22.68) vs. 1.14 (0.32-17.63), p < 0.001]. In regression analysis, total sleep quality score, subjective sleep quality and age were found to be independent negative factors for soluble Klotho levels. CONCLUSION In this study, a significant association between sleep quality and soluble Klotho levels was revealed in hemodialysis patients. Improving sleep quality will lead to increased soluble Klotho levels, which may further slow down the aging process in hemodialysis patients.
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Affiliation(s)
- Mustafa Topal
- Clinic of Nephrology, Konya City Hospital, University of Health Sciences, Akabe Mahallesi Adana Çevreyolu Caddesi No: 135/1, 42020, Konya, Turkey.
| | - Edip Erkus
- Clinic of Nephrology, Konya City Hospital, University of Health Sciences, Akabe Mahallesi Adana Çevreyolu Caddesi No: 135/1, 42020, Konya, Turkey
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Gao J, Liu Y, Ning N, Wang J, Li X, Wang A, Chen S, Guo L, Wu Z, Qin X, Ma Y, Wu S. Better Life's Essential 8 Is Associated With Lower Risk of Diabetic Kidney Disease: A Community-Based Study. J Am Heart Assoc 2023; 12:e029399. [PMID: 37646221 PMCID: PMC10547362 DOI: 10.1161/jaha.123.029399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 07/18/2023] [Indexed: 09/01/2023]
Abstract
Background Diabetic kidney disease (DKD) is a common diabetic complication and increases the complexity of diabetes management. No prospective study has focused on the association between DKD and Life's Essential 8 (LE8). Our study aims to examine the association between LE8 and DKD risk. Methods and Results A total of 7605 participants, aged 54.32±9.77 years, and 4688 participants, aged 56.11±10.38 years, were included in the longitudinal and trajectory analyses, respectively, from 2006 to 2020. The DKD was confirmed using data collected during each follow-up. LE8 was based on 4 health behaviors and 4 health factors. The range of each metric was 0 to 100, and the overall LE8 score was calculated as the unweighted average of all 8 component metric scores. The trajectories of LE8 during 2006 to 2010 were classified using latent mixture models. Cox models and restricted cubic splines were applied. After a median follow-up of 12.41 and 6.71 years in longitudinal and trajectory analyses, respectively, the DKD incidence decreased, with the LE8 level increasing (P-trend<0.05), and the linearity assumption for this relationship (P-nonlinear=0.685) had been satisfied. Adjusted hazard ratios (HRs) for the highest tertile were 0.77 (95% CI, 0.69-0.87) and 0.70 (95% CI, 0.62-0.78) in baseline and time-updated LE8 scores, respectively, compared with the lowest tertile. Adjusted HR was 0.53 (95% CI, 0.41-0.69) for the stable-high pattern compared with the stable-low pattern. Conclusions Although LE8 is an indicator of cardiovascular health, the beneficial impact of a high LE8 score is also evident in the protection of renal health among patients with diabetes.
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Affiliation(s)
- Jingli Gao
- Department of Intensive Care UnitKailuan General HospitalTangshanHebeiChina
| | - Yang Liu
- Department of Epidemiology and Biostatistics, School of Public HealthChina Medical UniversityShenyangLiaoningChina
| | - Ning Ning
- Department of Epidemiology and Biostatistics, School of Public HealthChina Medical UniversityShenyangLiaoningChina
| | - Jing Wang
- Peking University Medical Informatics Center, Peking UniversityBeijingChina
| | - Xiaolan Li
- Department of Intensive Care UnitKailuan General HospitalTangshanHebeiChina
| | - Aitian Wang
- Department of Intensive Care UnitKailuan General HospitalTangshanHebeiChina
| | - Shuohua Chen
- Department of CardiologyKailuan General HospitalTangshanHebeiChina
| | - Liang Guo
- Department of CardiologyRenmin Hospital of Wuhan UniversityWuhanHubeiChina
- Cardiovascular Research Institute of Wuhan UniversityWuhanChina
- Hubei Key Laboratory of CardiologyWuhanChina
| | - Zhaogui Wu
- Department of CardiologyTianjin Medical University, General HospitalTianjinChina
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Yanan Ma
- Department of Epidemiology and Biostatistics, School of Public HealthChina Medical UniversityShenyangLiaoningChina
| | - Shouling Wu
- Department of CardiologyKailuan General HospitalTangshanHebeiChina
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Xu S, Jin J, Dong Q, Gu C, Wu Y, Zhang H, Yin Y, Jia H, Lei M, Guo J, Xu H, Chang S, Zhang F, Hou Z, Zhang L. Association between sleep duration and quality with rapid kidney function decline and development of chronic kidney diseases in adults with normal kidney function: The China health and retirement longitudinal study. Front Public Health 2023; 10:1072238. [PMID: 36743175 PMCID: PMC9891205 DOI: 10.3389/fpubh.2022.1072238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/21/2022] [Indexed: 01/19/2023] Open
Abstract
Research have shown that sleep is associated with renal function. However, the potential effects of sleep duration or quality on kidney function in middle-aged and older Chinese adults with normal kidney function has rarely been studied. Our study aimed to investigate the association of sleep and kidney function in middle-aged and older Chinese adults. Four thousand and eighty six participants with an eGFR ≥60 ml/min/1.73 m2 at baseline were enrolled between 2011 and 2015 from the China Health and Retirement Longitudinal Study. Survey questionnaire data were collected from conducted interviews in the 2011. The eGFR was estimated from serum creatinine and/or cystatin C using the Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPI). The primary outcome was defined as rapid kidney function decline. Secondary outcome was defined as rapid kidney function decline with clinical eGFR of <60 ml/min/1.73 m2 at the exit visit. The associations between sleep duration, sleep quality and renal function decline or chronic kidney disease (CKD) were assessed based with logistic regression model. Our results showed that 244 (6.0%) participants developed rapid decline in kidney function, while 102 (2.5%) developed CKD. In addition, participants who had 3-7 days of poor sleep quality per week had higher risks of CKD development (OR 1.86, 95% CI 1.24-2.80). However, compared with those who had 6-8 h of night-time sleep, no significantly higher risks of rapid decline in kidney function was found among those who had <6 h or >8 h of night time sleep after adjustments for demographic, clinical, or psychosocial covariates. Furthermore, daytime nap did not present significant risk in both rapid eGFR decline or CKD development. In conclusion, sleep quality was significantly associated with the development of CKD in middle-aged and older Chinese adults with normal kidney function.
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Affiliation(s)
- Sujuan Xu
- Department of Nephrology, Third Hospital of Hebei Medical University, Shijiazhuang, China,Department of Orthopaedical Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China,Orthopaedic Research Institute of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Jifu Jin
- Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qi Dong
- Department of Orthopaedical Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China,Orthopaedic Research Institute of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Chenjie Gu
- The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yong Wu
- Department of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China,Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Haibo Zhang
- Department of Liver Disease, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yingchao Yin
- Department of Orthopaedical Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China,Orthopaedic Research Institute of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Huiyang Jia
- Department of Orthopaedical Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China,Orthopaedic Research Institute of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Mingcheng Lei
- Department of Rehabilitation Medicine, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Junfei Guo
- Department of Orthopaedical Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China,Orthopaedic Research Institute of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Haixia Xu
- Department of Cardiology, Affiliated Hospital of Nantong University, Jiangsu, China
| | - Suchi Chang
- Department of Cardiology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Feng Zhang
- Department of Rehabilitation Medicine, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhiyong Hou
- Department of Orthopaedical Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China,Orthopaedic Research Institute of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Liping Zhang
- Department of Physiology, Hebei Medical University, Shijiazhuang, Hebei, China,*Correspondence: Liping Zhang ✉
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Ho YF, Hsu PT, Yang KL. The mediating effect of sleep quality and fatigue between depression and renal function in nondialysis chronic kidney disease: a cross-sectional study. BMC Nephrol 2022; 23:126. [PMID: 35361150 PMCID: PMC8969389 DOI: 10.1186/s12882-022-02757-z] [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: 12/16/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depressive symptoms, fatigue, and poor sleep quality are associated with renal function deterioration in patients with nondialysis chronic kidney disease (CKD-ND). This study was designed to examine whether fatigue and sleep quality are mediators of the association between depression and renal function. METHODS This study adopted a cross-sectional study design. Patients with CKD-ND aged 20 years or older were recruited by purposive sampling at a medical center in Central Taiwan from December 2020 to July 2021. Data were collected using the Emotional and Social Support Scale, Fatigue Scale, Beck Depression Inventory-II (BDI-II), and Pittsburgh Sleep Quality Index. Medical records were reviewed to obtain the estimated glomerular filtration rate (eGFR) for the next month. The relationships among variables were analyzed using structural equation modeling to assess the goodness-of-fit of the model. Then, the bootstrapping method was used to analyze the mediated effect. RESULTS Two hundred forty-two participants (mean age 70.5 years and 53% males) were included in the analysis. About 39% of the participants met the criteria for depressive symptoms in BDI-II, and 91% reported having sleep disturbances. Participants' degree of fatigue was not high (20.4 ± 13.3). The average eGFR was 25.45 mL/min/1.73 m 2 (± 13.36). The results showed that fatigue, sleep quality, and eGFR were significantly correlated with depression. The total effect size was - 0.8304 (95% confidence interval [CI], - 0.9602 to - 0.7006), and the indirect effect size was - 0.1738 (95% CI, - 0.2812 to - 0.0651), which was a statistically significant difference, indicating that the model has a mediating effect. According to mediation analysis, fatigue and sleep quality had a significant indirect effect on the relationship between depression and renal function (95% CI, - 0.0587 to - 0.0039). CONCLUSIONS The findings suggest that fatigue and poor sleep quality may mediate the association between depression and renal function.
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Affiliation(s)
- Ya-Fang Ho
- School of Nursing, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist, Taichung City, 406040, Taiwan ROC.
| | - Pei-Ti Hsu
- Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan, ROC
| | - Kai-Ling Yang
- Nephrology Medicine, China Medical University Hospital, Taichung, Taiwan, ROC
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Relationship between modifiable lifestyle factors and chronic kidney disease: a bibliometric analysis of top-cited publications from 2011 to 2020. BMC Nephrol 2022; 23:120. [PMID: 35337272 PMCID: PMC8957172 DOI: 10.1186/s12882-022-02745-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) affects 8 to 16% of the world's population and is one of the top ten important drivers of increasing disease burden. Apart from genetic predisposition, lifestyle factors greatly contribute to the incidence and progression of CKD. The current bibliometric analysis aims to characterize the current focus and emerging trends of the research about the impact of modifiable lifestyle factors on CKD. METHODS We searched articles addressing the impact of modifiable lifestyle factors on the incidence and/or progression of CKD, published between 2011 and 2020, from the Science Citation Index Expanded (SCIE) database. An adjusted citation index, which considered both the original citation count and publication year, was derived for the selection of most-cited publications. Publishing trends, co-authorship network, keywords, and research hotspots were analyzed and visualized. RESULTS Among the top 100 most influential articles, 32 were narrative reviews, 16 systematic reviews and/or meta-analysis, 44 clinical research, and 8 basic research. The United States occupied a dominant position in the perspective of article numbers and international partnerships, followed by European countries. The modifiable factors that drew the most and constant attention over the decade were diet or nutrition management reported in 63 papers, followed by obesity or body mass index (n = 27), and physical activity or exercises (n = 8). Alcohol consumption, fish oil, chain fatty-acids, and water-soluble vitamins were emerging hotspots identified in the recent most cited publications. CONCLUSIONS Based on the bibliometric analysis of the most influential articles, our study provides a comprehensive description of publishing trends and research focus over a decade in the field of lifestyle factors' impact on CKD. Diet, obesity, and physical activity were factors receiving the most attention in this topic.
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Zhang H, Wang B, Chen C, Sun Y, Chen J, Tan X, Xia F, Zhang J, Lu Y, Wang N. Sleep Patterns, Genetic Susceptibility, and Incident Chronic Kidney Disease: A Prospective Study of 370 671 Participants. Front Neurosci 2022; 16:725478. [PMID: 35173575 PMCID: PMC8843034 DOI: 10.3389/fnins.2022.725478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 01/10/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives Unhealthy sleep behaviors may be potential risk factors for chronic kidney disease (CKD). We aimed to examine the associations of combined sleep patterns and genetic susceptibility with incident CKD. Methods This large-scale prospective cohort study included 370,671 participants without CKD at baseline (2006–2010) in UK Biobank data. Five sleep behaviors were made up of sleep duration, insomnia, snoring, chronotype, and daytime sleepiness according to questionnaire. Overall sleep patterns by summing the five scores were created. Weighted genetic risk score of kidney function was calculated. Incident CKD was recorded from death register, primary care, and hospital inpatient records. A subset of 41,130 individuals who participated both the initial assessment visit and follow-up visit (2012+) was also used. Results During a median follow-up of 10.6 years (about 3.9 million person-years), we documented 6,365 patients with incident CKD. In five sleep behaviors, sleep 7–8 h/day, free of insomnia and no frequent daytime sleepiness were independently associated with incident CKD, with a 12% (95%CI 7–16), 9% (3–14), 13% (9–18) lower risk, respectively. Compared to those with a sleep score of 0–1, participants with a score of 5 had a 21% (10–31%) lower risk of CKD. 17.1% of CKD in this cohort could be attributed to total poor sleep pattern. Participants with high genetic risk and intermediate or poor sleep pattern showed the highest risk of CKD (OR = 2.58, 95%CI 2.24–2.96; OR = 2.59, 95%CI 2.02–3.32, respectively), although there was no significant interaction between sleep patterns and genetic risk categories. Among individuals who participated both the initial assessment visit and follow-up visit, we found that the association between amelioration of sleep pattern and risk of CKD was significant after fully adjustment (OR = 0.60, 95%CI 0.36–0.99), compared with group of stable sleep pattern. Conclusion In this large prospective study, participants with a healthy sleep pattern was associated with a significant reduction of incident CKD risk no matter they had a high, intermediate, or low genetic risk.
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Affiliation(s)
- Haojie Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Chi Chen,
| | - Ying Sun
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Chen
- Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Xiao Tan
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jihui Zhang
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Jihui Zhang,
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yingli Lu,
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ningjian Wang,
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9
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Li J, Cao D, Huang Y, Chen Z, Wang R, Dong Q, Wei Q, Liu L. Sleep duration and health outcomes: an umbrella review. Sleep Breath 2021; 26:1479-1501. [PMID: 34435311 DOI: 10.1007/s11325-021-02458-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/18/2021] [Accepted: 07/28/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To collect existing evidence on the relationship between sleep duration and health outcomes. METHODS A thorough search was conducted in PubMed, Web of Science, Embase, and the Cochrane Database of Systematic Reviews from inception to January, 2021. Meta-analyses of observational and interventional studies were eligible if they examined the associations between sleep duration and human health. RESULTS In total, this umbrella review identified 69 meta-analyses with 11 outcomes for cancers and 30 outcomes for non-cancer conditions. Inappropriate sleep durations may significantly elevate the risk for cardiovascular disease (CVD), cognitive decline, coronary heart disease (CHD), depression, falls, frailty, lung cancer, metabolic syndrome (MS), and stroke. Dose-response analysis revealed that a 1-h reduction per 24 hours is associated with an increased risk by 3-11% of all-cause mortality, CHD, osteoporosis, stroke, and T2DM among short sleepers. Conversely, a 1-h increment in long sleepers is associated with a 7-17% higher risk of stroke mortality, CHD, stroke, and T2DM in adults. CONCLUSION Inappropriate sleep duration is a risk factor for developing non-cancer conditions. Decreasing and increasing sleep hours towards extreme sleep durations are associated with poor health outcomes.
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Affiliation(s)
- Jin Li
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Dehong Cao
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Yin Huang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Zeyu Chen
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Ruyi Wang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Dong
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Wei
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
| | - Liangren Liu
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
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10
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Mazidi M, Shekoohi N, Katsiki N, Banach M. Longer sleep duration may negatively affect renal function. Int Urol Nephrol 2021; 53:325-332. [PMID: 32970283 PMCID: PMC7862211 DOI: 10.1007/s11255-020-02624-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 08/24/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Observational studies evaluating the link between sleep duration and kidney function reported controversial results. In the present study, Mendelian randomization analysis was applied to obtain unconfounded estimates of the casual association of genetically determined sleep duration with estimated glomerular filtration rate and the risk of chronic kidney disease. METHODS Data from the largest genome-wide association studies on self-reported and accelerometer-derived sleep duration, estimated glomerular filtration rate and chronic kidney disease were analysed in total, as well as separately in diabetic and non-diabetic individuals. Inverse variance weighted (IVW) method, weighted median-based method, MR-Egger and MR-Pleiotropy RESidual Sum and Outlier (MR-PRESSO) were applied, as well as the leave-one-out method to rule out the impact of single single-nucleotide polymorphism. RESULTS Individuals with genetically longer self-reported sleep duration had a higher chronic kidney disease risk (IVW: β = 0.358, p = 0.047). Furthermore, in non-diabetics, longer self-reported sleep duration was negatively associated with estimated glomerular filtration rate (IVW: β = - 0.024, p = 0.020). Similarly, accelerometer-derived sleep duration was negatively related to estimated glomerular filtration rate in the total population (IVW: β = - 0.019, p = 0.047) and then on-diabetic individuals. No significant association was found between self-reported sleep duration and estimated glomerular filtration rate in the whole population and type-2 diabetes mellitus patients. None of the estimated associations was subjected to a significant level of heterogeneity. MR-PRESSO analysis did not show any chance of outliers for all estimates. The pleiotropy test also indicated low chance of pleiotropy. The leave-one-out method demonstrated that the links were not driven by single-nucleotide polymorphisms. CONCLUSIONS For the first time, the present study shed a light on the potential harmful effects of longer sleep duration (measured both objectively and subjectively) on kidney function. This finding was observed in the total population and in non-diabetic individuals, but not in those with diabetes. Further research is needed to elucidate the links between sleep duration, estimated glomerular filtration rate and the risk of chronic kidney disease.
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Affiliation(s)
- Mohsen Mazidi
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Campus, Lambeth Palace Road, London, SE1 7EH, UK.
| | - Niloofar Shekoohi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, University of Medical Sciences, Tehran, Iran
| | - Niki Katsiki
- First Department of Internal Medicine, Center for Diabetes, Metabolism and Endocrinology, AHEPA University Hospital, Thessaloniki, Greece
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, WAM University Hospital, Medical University of Lodz, Zeromskiego 113, 90-549, Lodz, Poland.
- Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland.
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland.
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11
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Role of physical activity and fitness on sleep in sedentary middle-aged adults: the FIT-AGEING study. Sci Rep 2021; 11:539. [PMID: 33436671 PMCID: PMC7804461 DOI: 10.1038/s41598-020-79355-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/01/2020] [Indexed: 12/12/2022] Open
Abstract
The association of physical activity and fitness with sleep still remains unclear since there is a lack of studies in this field of research using objective measurements of these variables. This study aimed to investigate the association of objectively-measured sedentariness, physical activity levels, and physical fitness with sleep quantity and quality in sedentary middle-aged adults. A total of 74 volunteers (52.7% women; aged 53.7 ± 5.1) were recruited for the present study. Cardiorespiratory fitness was measured through a maximal treadmill test, and muscular strength by extension and flexion peak torque, and by the hand grip test. Physical activity and objective sleep parameters were determined through accelerometry, and subjective sleep by the Pittsburgh Sleep Quality Index (PSQI). Reduced levels of sedentariness, greater VO2max, and greater muscular strength were positively related to improved objective sleep quantity and quality (all P ≤ 0.05). Furthermore, higher levels of overall physical activity, VO2max, and muscular strength were related to better subjective sleep quantity and quality (all P ≤ 0.05). Reduced sedentariness and increased physical activity and fitness may be a potential prevention and/or treatment pathway to reduce sleep disturbances and, in general, to improve patients physical and psychological health for a successful aging process.
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12
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Jackson CL, Umesi C, Gaston SA, Azarbarzin A, Lunyera J, McGrath JA, Jackson Ii WB, Diamantidis CJ, Boulware E, Lutsey PL, Redline S. Multiple, objectively measured sleep dimensions including hypoxic burden and chronic kidney disease: findings from the Multi-Ethnic Study of Atherosclerosis. Thorax 2020; 76:704-713. [PMID: 33277428 DOI: 10.1136/thoraxjnl-2020-214713] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 10/23/2020] [Accepted: 10/30/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Poor sleep may contribute to chronic kidney disease (CKD) through several pathways, including hypoxia-induced systemic and intraglomerular pressure, inflammation, oxidative stress and endothelial dysfunction. However, few studies have investigated the association between multiple objectively measured sleep dimensions and CKD. METHODS We investigated the cross-sectional association between sleep dimensions and CKD among 1895 Multi-Ethnic Study of Atherosclerosis Sleep Ancillary Study participants who completed in-home polysomnography, wrist actigraphy and a sleep questionnaire. Using Poisson regression models with robust variance, we estimated separate prevalence ratios (PR) and 95% CIs for moderate-to-severe CKD (glomerular filtration rate <60 mL/min/1.73 m2 or albuminuria >30 mg/g) among participants according to multiple sleep dimensions, including very short (≤5 hours) sleep, Apnoea-Hypopnoea Index and sleep apnoea-specific hypoxic burden (SASHB) (total area under the respiratory event-related desaturation curve divided by total sleep duration, %min/hour)). Regression models were adjusted for sociodemographic characteristics, health behaviours and clinical characteristics. RESULTS Of the 1895 participants, mean age was 68.2±9.1 years, 54% were women, 37% were white, 28% black, 24% Hispanic/Latino and 11% Asian. Several sleep metrics were associated with higher adjusted PR of moderate-to-severe CKD: very short versus recommended sleep duration (PR=1.40, 95% CI 1.06 to 1.83); SASHB (Box-Cox transformed SASHB: PR=1.06, 95% CI 1.02 to 1.12); and for participants in the highest quintile of SASHB plus sleep apnoea: PR=1.28, 95% CI 1.01 to 1.63. CONCLUSIONS Sleep apnoea associated hypoxia and very short sleep, likely representing independent biological mechanisms, were associated with a higher moderate-to-severe CKD prevalence, which highlights the potential role for novel interventions.
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Affiliation(s)
- Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA .,Intramural Program, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Chizoba Umesi
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA.,Duke University School of Medicine, Durham, North Carolina, USA
| | - Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Ali Azarbarzin
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Joseph Lunyera
- Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - John A McGrath
- Social & Scientific Systems Inc, Durham, North Carolina, USA
| | | | - Clarissa J Diamantidis
- Duke University School of Medicine, Durham, North Carolina, USA.,Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ebony Boulware
- Duke University School of Medicine, Durham, North Carolina, USA.,Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Pamela L Lutsey
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Medicine, Division of Pulmonary Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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13
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Mochón-Benguigui S, Carneiro-Barrera A, Castillo MJ, Amaro-Gahete FJ. Is Sleep Associated with the S-Klotho Anti-Aging Protein in Sedentary Middle-Aged Adults? The FIT-AGEING Study. Antioxidants (Basel) 2020; 9:antiox9080738. [PMID: 32806634 PMCID: PMC7463654 DOI: 10.3390/antiox9080738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 11/16/2022] Open
Abstract
Sleep and Klotho have both been closely related to the ageing process, both playing a substantial role in the endocrine and immune systems and, thereby, in oxidative stress and chronic inflammation. However, there are no studies elucidating the relationship between sleep and Klotho. Therefore, this study investigated the association of sleep quantity and quality with the shed form of the α-Klotho gene (S-Klotho plasma levels) in sedentary middle-aged adults. A total of 74 volunteers (52.7% women; aged 53.7 ± 5.1) were recruited for the present study. Objective sleep quality parameters (total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE)) were determined using a wrist-worn accelerometer over seven consecutive days, and the subjective sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI; higher scores indicate worse sleep quality). The S-Klotho plasma levels were measured in the ethylenediaminetetraacetic acid plasma using a solid-phase sandwich enzyme-linked immunosorbent assay. Objective sleep parameters were associated with the S-Klotho plasma levels only after including the age, fat mass percentage, and lean mass index as covariates. A direct relationship was observed between the subjective sleep quality (inverse of PSQI scores) and the S-Klotho plasma levels in sedentary middle-aged adults. Improving sleep quantity and quality could be considered an anti-aging therapeutic approach for the prevention, slowing, and even reversal of the physiological decline and degenerative pathologies that are certainly related to the aging process.
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Affiliation(s)
- Sol Mochón-Benguigui
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain;
- Correspondence: (S.M.-B.); (F.J.A.-G.)
| | - Almudena Carneiro-Barrera
- Sleep and Health Promotion Laboratory, Mind, Brain and Behaviour Research Centre (CIMCYC), University of Granada, 18011 Granada, Spain;
| | - Manuel J. Castillo
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain;
| | - Francisco J. Amaro-Gahete
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain;
- Correspondence: (S.M.-B.); (F.J.A.-G.)
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14
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Full KM, Jackson CL, Rebholz CM, Matsushita K, Lutsey PL. Obstructive Sleep Apnea, Other Sleep Characteristics, and Risk of CKD in the Atherosclerosis Risk in Communities Sleep Heart Health Study. J Am Soc Nephrol 2020; 31:1859-1869. [PMID: 32591438 DOI: 10.1681/asn.2020010024] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/19/2020] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea may be associated with development of CKD through hypoxia, inflammation, and oxidative stress. Individuals with this sleep disorder are also at increased risk for established CKD risk factors, including obesity, hypertension, and type 2 diabetes. METHODS We examined the association between obstructive sleep apnea, other sleep characteristics, and risk of incident CKD (stage 3 or higher) in 1525 participants (mean age, 62.5 years; 52.4% women) in the Atherosclerosis Risk in Communities (ARIC) study who completed in-home polysomnography assessments. We used the apnea-hypopnea index (events per hour) to define obstructive sleep apnea severity (normal, <5.0; mild, 5.0-14.9; moderate, 15.0-29.9; and severe, ≥30.0) and defined incident CKD (stage 3 or higher) as eGFR<60 ml/min per 1.73 m2 and ≥25% decline from baseline, CKD-related hospitalization or death, or ESKD. Cox proportional hazards regression was used to estimate obstructive sleep apnea severity with risk of incident CKD, adjusting for demographics, lifestyle behaviors, and cardiometabolic conditions. RESULTS During 19 years (median) of follow-up, 461 CKD events occurred. After adjustment for demographics and lifestyle behaviors, severe obstructive sleep apnea associated with increased risk of CKD (hazard ratio [HR], 1.51; 95% confidence interval [95% CI], 1.08 to 2.10), which was attenuated after adjustment for body mass index (HR, 1.07; 95% CI, 0.75 to 1.52). No other sleep characteristics associated with incident CKD. CONCLUSIONS We found a link between obstructive sleep apnea and an elevated risk of stage 3 CKD or higher, but this association was no longer significant after adjusting for obesity, a risk factor for both conditions. Given the high prevalence of obstructive sleep apnea and CKD among adults, further investigation is warranted.
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Affiliation(s)
- Kelsie M Full
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Chapel Hill, North Carolina.,Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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15
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Hao Q, Xie M, Zhu L, Dou Y, Dai M, Wu Y, Tang X, Wang Q. Association of sleep duration with chronic kidney disease and proteinuria in adults: a systematic review and dose-response meta-analysis. Int Urol Nephrol 2020; 52:1305-1320. [PMID: 32418007 DOI: 10.1007/s11255-020-02488-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/29/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND OBJECTIVES Previous studies have found that sleep duration may be associated with chronic kidney disease (CKD) and proteinuria in adults. However, the correlation remains controversial. In this study, we aimed to assess the effects of sleep duration on CKD and proteinuria. METHODS PubMed, EMBASE, and Cochrane Library were searched from their inception up to April 5, 2019 for observational study. The outcomes were CKD and/or proteinuria and the exposure was sleep duration assessed by self-reported questionnaire or interview. Studies were included if they provided risk estimates of effects of sleep duration on patients with CKD or proteinuria. The overall effects were measured by odds ratios (OR) and 95% confidence intervals (CI). Heterogeneity was quantified using Q statistics and the I2 statistics. The potential causes of heterogeneity were investigated using sensitivity analysis. RESULTS Eleven observational studies with 521,242 individuals were included. The adjusted ORs of CKD in individuals who slept ≤ 6 h/night and ≥ 8 h/night were 1.13 (95% CI, 1.02-1.25; I2 = 29%) and 1.14 (95% CI, 1.07-1.22; I2= 0%), respectively. Meanwhile, the adjusted ORs of proteinuria in those who slept ≤ 6 h/night and ≥ 8 h/night were 1.24 (95% CI, 1.06-1.44; I2 = 61%) and 1.15 (95% CI, 1.04-1.29; I2 = 0%), respectively. Furthermore, a U-shaped relationship was observed between sleep duration and CKD or proteinuria, with the lowest risk at 7 h/night of sleep. CONCLUSIONS Both short and long sleep durations are significantly associated with CKD and proteinuria. Our findings suggest curvilinear dose-response associations of sleep duration with CKD and proteinuria.
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Affiliation(s)
- Qinjian Hao
- The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Min Xie
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ling Zhu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yikai Dou
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Minhan Dai
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yulu Wu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiangdong Tang
- Sleep Medicine Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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16
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Sleep debt and prevalence of proteinuria in subjects with short sleep duration on weekdays: a cross-sectional study. Clin Exp Nephrol 2019; 24:143-150. [PMID: 31691047 DOI: 10.1007/s10157-019-01808-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 10/23/2019] [Indexed: 12/17/2022]
Abstract
STUDY OBJECTIVE Short sleep duration is a risk factor of chronic kidney disease, along with cardiovascular diseases and all-cause mortality. Several studies reported that many people sleep longer on weekends than on weekdays, suggesting that they should be compensated for their sleep debt on weekdays on the weekends. Few studies have reported the clinical impact of sleep debt on the kidney. METHODS This cross-sectional study included 5799 employees of Osaka University who visited its Health Care Center for their annual health examinations and answered ≤ 6 h of sleep duration on weekdays. The independent variable was the sleep debt index defined as a gap in self-reported sleep duration (≤ 5, 5-6, 6-7, 7-8, 8-9, and ≥ 9 h) between weekdays and weekends, which was categorized into ≤ 0, + 1, + 2, + 3 and ≥+4. An association between the sleep debt index and a prevalence of proteinuria defined as dipstick proteinuria of ≥ 1 + was assessed using logistic regression models adjusting for clinically relevant factors. RESULTS More than four-fifths of the subjects had a positive sleep debt index (≤ 0, + 1, + 2, + 3, and ≥+4 recorded for 19%, 36%, 28%, 11%, and 6%, respectively). The multivariable-adjusted logistic regression models showed the sleep debt index ≥ 3 + was significantly associated with the prevalence of proteinuria (sleep debt index ≤ 0, adjusted odds ratio 1.13 [0.77, 1.65]; + 1, 1.00 [reference]; + 2, 1.29 [0.93, 1.79]; + 3, 1.54 [1.02, 2.33]; ≥ + 4, 1.87 [1.15, 3.05]). CONCLUSIONS Sleep debt was associated with the prevalence of proteinuria in a dose-dependent manner.
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17
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Kim S, Uhm JY. Individual and Environmental Factors Associated with Proteinuria in Korean Children: A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183317. [PMID: 31505832 PMCID: PMC6766052 DOI: 10.3390/ijerph16183317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 07/27/2019] [Accepted: 07/31/2019] [Indexed: 02/06/2023]
Abstract
Proteinuria is a significant sign of childhood renal disorders. However, little is known about how sociodemographic and environmental factors are related to the presence of proteinuria among children and adolescents. This paper focuses on the prevalence of proteinuria and its risk factors among children and adolescents. This study conducted a secondary analysis of data from the 2016 Sample Schools Raw Data of Health Examination for School Students (SSRDHESS). Data collected from 27,081 students who had undergone a health screening were analyzed using Chi-square tests, independent t-tests, and multilevel logistic regression analysis. The prevalence of proteinuria was higher in the thin group than in the normal weight group (adjusted odds ratio (aOR) = 1.77; 95% confidence interval (CI) = 1.34–2.33) and lower in the overweight/obese group (aOR = 0.64; 95% CI = 0.51–0.80). Additionally, those in metropolitan and small–medium sized cities had a proteinuria prevalence about 1.5-fold higher than that of those in rural areas (95% CI = 1.08–2.02, 95% CI = 1.19–1.92, respectively). Proteinuria was associated with environmental pollution, including smoking rate, ambient particulate matter and heavy metals in drinking water (aOR = 1.10; 95% CI = 1.01–1.20; aOR = 1.06; 95% CI = 1.01–1.11, aOR = 1.001; 95% CI = 1.0001–1.0015). These results suggest that to improve health management effectiveness, kidney disease prevention efforts for children and adolescents should focus on geographical area and environmental pollution, as well as body weight as individual factors.
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Affiliation(s)
- Suhee Kim
- School of Nursing and Research Institute of Nursing Science, Hallym University, Chuncheon-si, Gangwon-do 24252, Korea.
| | - Ju-Yeon Uhm
- Department of Nursing, Pukyong National University, Busan 48513, Korea.
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18
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Lunyera J, Davenport CA, Jackson CL, Johnson DA, Bhavsar NA, Sims M, Scialla JJ, Stanifer JW, Pendergast J, McMullan CJ, Ricardo AC, Boulware LE, Diamantidis CJ. Evaluation of Allostatic Load as a Mediator of Sleep and Kidney Outcomes in Black Americans. Kidney Int Rep 2019; 4:425-433. [PMID: 30899870 PMCID: PMC6409364 DOI: 10.1016/j.ekir.2018.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 01/18/2023] Open
Abstract
Introduction Poor sleep associates with adverse chronic kidney disease (CKD) outcomes yet the biological mechanisms underlying this relation remain unclear. One proposed mechanism is via allostatic load, a cumulative biologic measure of stress. Methods Using data from 5177 Jackson Heart Study participants with sleep measures available, we examined the association of self-reported sleep duration: very short, short, recommended, and long (≤5, 6, 7–8, or ≥9 hours per 24 hours, respectively) and sleep quality (high, moderate, low) with prevalent baseline CKD, and estimated glomerular filtration rate (eGFR) decline and incident CKD at follow-up. CKD was defined as eGFR <60 ml/min per 1.73 m2 or urine albumin-to-creatinine ratio ≥30 mg/g. Models were adjusted for demographics, comorbidities, and kidney function. We further evaluated allostatic load (quantified at baseline using 11 biomarkers from neuroendocrine, metabolic, autonomic, and immune domains) as a mediator of these relations using a process analysis approach. Results Participants with very short sleep duration (vs. 7–8 hours) had greater odds of prevalent CKD (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.03–1.66). Very short, short, or long sleep duration (vs. 7–8 hours) was not associated with kidney outcomes over a median follow-up of 8 years. Low sleep quality (vs. high) associated with greater odds of prevalent CKD (OR 1.26, 95% CI 1.00–1.60) and 0.18 ml/min per 1.73 m2 (95% CI 0.00–0.36) faster eGFR decline per year. Allostatic load did not mediate the associations of sleep duration or sleep quality with kidney outcomes. Conclusions Very short sleep duration and low sleep quality were associated with adverse kidney outcomes in this all-black cohort, but allostatic load did not appear to mediate these associations.
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Affiliation(s)
- Joseph Lunyera
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Correspondence: Joseph Lunyera, Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, 200 Morris Street, Durham, North Carolina 27701, USA.
| | - Clemontina A. Davenport
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Chandra L. Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Dayna A. Johnson
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nrupen A. Bhavsar
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mario Sims
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Julia J. Scialla
- Duke Clinical Research Institute, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - John W. Stanifer
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jane Pendergast
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ciaran J. McMullan
- Renal Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Ana C. Ricardo
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - L. Ebony Boulware
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Clarissa J. Diamantidis
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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19
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Calero K, Anderson WM. Can Poor Sleep Cause Kidney Disease? Another Step Closer to the Answer. J Clin Sleep Med 2019; 15:371-372. [PMID: 30853058 DOI: 10.5664/jcsm.7652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Karel Calero
- College of Medicine, Pulmonary, Critical Care and Sleep Medicine, University of South Florida, Tampa, Florida
| | - William McDowell Anderson
- College of Medicine, Pulmonary, Critical Care and Sleep Medicine, University of South Florida, Tampa, Florida
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20
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Geng TT, Jafar TH, Yuan JM, Koh WP. Sleep duration and risk of end-stage renal disease: the Singapore Chinese Health Study. Sleep Med 2018; 54:22-27. [PMID: 30529773 DOI: 10.1016/j.sleep.2018.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/26/2018] [Accepted: 10/11/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Although epidemiological evidence suggests that short sleep duration may affect renal function, the influence of long sleep and risk of end-stage renal disease (ESRD) is unclear. We examined the association between sleep duration and risk of ESRD. METHODS We investigated sleep duration and ESRD risk in the Singapore Chinese Health Study, a prospective population-based cohort of 63,257 Chinese in Singapore, who were aged 45-74 years at recruitment (1993-1998). Information on daily sleep duration (including naps), diet, medical history and other lifestyle factors was collected at recruitment from in-person interviews. ESRD cases were identified via linkage with the nationwide Singapore Renal Registry through year 2014. We used the Cox proportional hazards regression method to estimate hazard ratio (HR) and 95% confidence interval (CI) of ESRD in relation to sleep duration. RESULTS After an average 16.8 years of follow-up, 1143 (1.81%) ESRD cases were documented. Sleep duration had a U-shaped association with risk of ESRD (P for quadratic trend < 0.001). Compared with participants with 7 h/day of sleep, the multivariable adjusted HR (95% CI) of ESRD was 1.43 (1.18-1.74) for short sleep (≤5 h/day) and 1.28 (1.03-1.60) for long sleep duration (≥9 h/day). The increased risk was stronger in participants with more than 10 years of follow-up compared to those with shorter follow-up time, especially for long sleep (P for interaction = 0.003). CONCLUSIONS Our findings demonstrated that both short and long sleep durations were associated with a higher risk of ESRD in this Asian population.
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Affiliation(s)
- Ting-Ting Geng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Tazeen Hasan Jafar
- Health Services and Systems Research, Duke-NUS Medical School, Singapore; Department of Renal Medicine, Singapore General Hospital, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA, USA
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Yu JH, Han K, Kim NH, Yoo HJ, Seo JA, Kim SG, Choi KM, Baik SH, Kim NH. U-shaped association between sleep duration and urinary albumin excretion in Korean adults: 2011-2014 Korea National Health and Nutrition Examination Survey. PLoS One 2018; 13:e0192980. [PMID: 29470498 PMCID: PMC5823398 DOI: 10.1371/journal.pone.0192980] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 02/01/2018] [Indexed: 12/30/2022] Open
Abstract
Although sleep duration has been extensively studied in metabolic diseases, few studies have investigated the impact of sleep duration on chronic kidney disease. The aim of this study was to examine the relationship between sleep duration and albuminuria in the general population. Among 24,948 adults who participated in the 2011–2014 KNHANES, a total of 19,994 subjects were included in this analysis. Subjects were categorized into the following five groups according to self-reported sleep duration: less than 5 h, 6 h, 7 h, 8 h, and more than 9 h. The association between sleep duration and urinary albumin-creatinine ratio (UACR) was examined cross-sectionally. Subjects with both short and long sleep durations were significantly associated with higher UACR levels and higher proportions of patients with microalbuminuria (30–299 mg/g) and macroalbuminuria (≥300 mg/g) compared to those with a sleep duration of 7 hours. The U-shaped association between sleep duration and UACR remained significant even after adjustment for potential confounders, including age, sex, body mass index, smoking, alcohol, education, income, exercise, estimated glomerular filtration rate, diabetes mellitus, hypertension and hypercholesterolemia. The U-shaped association is more evident in the subgroup aged 65 or older, or in female subjects. Our findings suggest that both short and long sleep durations have a U-shaped association with UACR levels in the general population, independent of potential confounders.
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Affiliation(s)
- Ji Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Kyungdo Han
- Department of Biostatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Ji A. Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
- * E-mail:
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22
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Tan NYQ, Chan J, Cheng CY, Wong TY, Sabanayagam C. Sleep Duration and Diabetic Kidney Disease. Front Endocrinol (Lausanne) 2018; 9:808. [PMID: 30692966 PMCID: PMC6340267 DOI: 10.3389/fendo.2018.00808] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/21/2018] [Indexed: 12/22/2022] Open
Abstract
Aims: Abnormally short or long durations of sleep have been proposed as a risk factors for diabetes and its micro- and macro-vascular complications. However, the relationship between sleep duration and diabetic kidney disease (DKD) has not been well-characterized. Thus, we aimed to examine the association of sleep duration with DKD in two Asian populations. Methods: We included 1,258 persons (Malay, n = 403; Indian, n = 855) aged 40-80 years with diabetes from a population-based cross-sectional sample from Singapore. DKD was defined by low estimated glomerular filtration rate (eGFR <60 mL/min/1.73 m2) and albuminuria (urinary albumin-to-creatinine ratio ≥30 mg/g, only measured in Indian participants). Self-reported habitual sleep duration was categorized into 4 categories: very short (<5 h), short (5-6.9 h), normal (7-8 h) and long (>8 h). The associations of sleep duration with low eGFR and albuminuria were analyzed using multivariable logistic regression models adjusted for multiple potential confounders (including classic risk factors such as HbA1c and hypertension). Results: In total, 268 (21.3%) participants had low eGFR, and 271 (34.7% in Indians) had albuminuria. The number (%) of individuals with very short, short, normal, and long durations of sleep were 117 (9.3%), 629 (50.0%), 429 (34.1%), and 83 (6.6%), respectively. Long sleep duration was associated with a higher odds of renal insufficiency compared to normal sleep duration (OR [95% CI]: 2.31 [1.27-4.19]) on multivariable analysis. Similarly, both long and very short durations of sleep were associated with higher odds of albuminuria (OR [95%]: 2.44 [1.36, 4.38] and 2.37 [1.25, 4.50], respectively) in Indian participants (where data on albuminuria were available). Conclusions: Our study suggests that abnormally short or long durations of sleep were associated with DKD, manifesting as either a reduced eGFR or increased albuminuria. However, further longitudinal data would be required for confirmation.
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Affiliation(s)
- Nicholas Y. Q. Tan
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | - Joel Chan
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Tien Yin Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- *Correspondence: Charumathi Sabanayagam
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Knutson KL, Lash J, Ricardo AC, Herdegen J, Thornton JD, Rahman M, Turek N, Cohan J, Appel LJ, Bazzano LA, Tamura MK, Steigerwalt SP, Weir MR, Van Cauter E. Habitual sleep and kidney function in chronic kidney disease: the Chronic Renal Insufficiency Cohort study. J Sleep Res 2017. [PMID: 28643350 DOI: 10.1111/jsr.12573] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Physiological evidence suggests that sleep modulates kidney function. Our objective was to examine the cross-sectional association between kidney function and objectively-estimated habitual sleep duration, quality and timing in a cohort of patients with mild to moderate chronic kidney disease. This study involved two US clinical centers of the Chronic Renal Insufficiency Cohort (CRIC) study, including 432 participants in a CRIC ancillary sleep study. Habitual sleep duration, quality and timing were measured using wrist actigraphy for 5-7 days. Validated sleep questionnaires assessed subjective sleep quality, daytime sleepiness and risk of sleep apnea. Kidney function was assessed with the estimated glomerular filtration rate using the Chronic Kidney Disease Epidemiology Collaboration equation, and the urinary protein to creatinine ratio. Lower estimated glomerular filtration rate was associated with shorter sleep duration (-1.1 mL min-1 1.73 m-2 per hour less sleep, P = 0.03), greater sleep fragmentation (-2.6 mL min-1 1.73 m-2 per 10% higher fragmentation, P < 0.001) and later timing of sleep (-0.9 mL min-1 1.73 m-2 per hour later, P = 0.05). Higher protein to creatinine ratio was also associated with greater sleep fragmentation (approximately 28% higher per 10% higher fragmentation, P < 0.001). Subjective sleep quality, sleepiness and persistent snoring were not associated with estimated glomerular filtration rate or protein to creatinine ratio. Thus, worse objective sleep quality was associated with lower estimated glomerular filtration rate and higher protein to creatinine ratio. Shorter sleep duration and later sleep timing were also associated with lower estimated glomerular filtration rate. Physicians treating patients with chronic kidney disease should consider inquiring about sleep and possibly sending for clinical sleep assessment. Longitudinal and interventional trials are needed to understand causal direction.
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Affiliation(s)
| | - James Lash
- Department of Medicine, University of Illinois, Chicago, IL, USA
| | - Ana C Ricardo
- Department of Medicine, University of Illinois, Chicago, IL, USA
| | | | - J D Thornton
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Mahboob Rahman
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Nicolas Turek
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Janet Cohan
- Department of Medicine, University of Illinois, Chicago, IL, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Manjula K Tamura
- Geriatric Research and Education Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | | | - Matthew R Weir
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Eve Van Cauter
- Department of Medicine, University of Chicago, Chicago, IL, USA
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Li J, Huang Z, Hou J, Sawyer AM, Wu Z, Cai J, Curhan G, Wu S, Gao X. Sleep and CKD in Chinese Adults: A Cross-Sectional Study. Clin J Am Soc Nephrol 2017; 12:885-892. [PMID: 28389618 PMCID: PMC5460709 DOI: 10.2215/cjn.09270816] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 03/11/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND OBJECTIVES To assess the association between self-reported sleep duration and quality and odds of having CKD in Chinese adults on the basis of a community study. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In this cross-sectional study, we included 11,040 Chinese adults who participated in an ongoing prospective study, the Kailuan cohort. Survey questionnaire items addressed insomnia, daytime sleepiness, snoring, and sleep duration during their 2012 interview. Overall sleep quality was evaluated by summarizing these four sleep parameters. Fasting blood samples and single random midstream morning urine samples were collected in 2012 and analyzed for serum creatinine and proteinuria. CKD was defined by eGFR<60 ml/min per 1.73 m2 or proteinuria >300 mg/dl. We also examined those at high or very high risk of having CKD, on the basis of the Kidney Disease Improving Global Outcomes recommendations. The association between sleep quality and CKD was assessed using logistic regression model. RESULTS Worse overall sleep quality was associated with higher likelihood of being high or very high risk for CKD (multiadjusted odds ratio, 2.69; 95% confidence interval, 1.30 to 5.59 comparing two extreme categories; P trend <0.01), but not overall CKD (multiadjusted odds ratio, 1.58; 95% confidence interval, 0.89 to 2.80 comparing two extreme categories; P trend =0.46), after adjusting for potential confounders. Specifically, individuals with worse sleep quality were more likely to have proteinuria (multiadjusted odds ratio, 1.95; 95% confidence interval, 1.03 to 3.67 comparing two extreme categories; P trend =0.02), rather than lower eGFR level (multiadjusted mean eGFR levels were 96.4 and 93.6 ml/min per 1.73 m2 in the two extreme sleep categories, respectively; P trend =0.13). However, there was no statistically significant association between individual sleep parameters and CKD status. CONCLUSIONS Worse overall sleep quality was associated with higher odds of being high or very high risk for CKD and proteinuria in Chinese adults.
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Affiliation(s)
| | - Zhe Huang
- Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, China
| | | | | | - Zhijun Wu
- Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianfang Cai
- Department of Nephrology and
- Clinical Epidemiology Unit, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing, China; and
| | - Gary Curhan
- The Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shouling Wu
- Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, China
| | - Xiang Gao
- Department of Nutritional Science, The Pennsylvania State University, State College, Pennsylvania
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25
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Kim CW, Chang Y, Sung E, Yun KE, Jung HS, Ko BJ, Kwon MJ, Hyun YY, Lee KB, Kim H, Shin H, Ryu S. Sleep duration and quality in relation to chronic kidney disease and glomerular hyperfiltration in healthy men and women. PLoS One 2017; 12:e0175298. [PMID: 28423054 PMCID: PMC5396878 DOI: 10.1371/journal.pone.0175298] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 03/23/2017] [Indexed: 12/21/2022] Open
Abstract
Background It is unclear whether sleep duration and quality are associated with chronic kidney disease (CKD) and glomerular hyperfiltration. The aim of this study was to examine the association of sleep duration and quality with CKD and glomerular hyperfiltration in young and middle-aged adults. Methods We conducted a cross-sectional study of men and women who underwent a health checkup examination, including assessment of sleep duration and quality (n = 241,607). Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m2, and glomerular hyperfiltration was defined as eGFR above the age-/sex-specific 95th percentile. Results In a multinomial logistic regression analysis adjusting for relevant confounders, the adjusted prevalence ratios for CKD (95% confidence interval) comparing sleep durations of ≤ 5, 6, 8, and 9 hours with 7 hours were 1.22 (0.95–1.55), 0.93 (0.75–1.14), 0.97 (0.75–1.26), and 1.56 (1.06–2.30) in men and 0.98 (0.68–1.43), 1.03 (0.72–1.46), 1.39 (0.97–2.00), and 1.31 (0.78–2.22) in women, respectively. The corresponding prevalence ratios (95% confidence interval) for glomerular hyperfiltration were 1.00 (0.93–1.08), 0.97 (0.91–1.03), 1.03 (0.94–1.13), and 1.39 (1.13–1.72) in men and 1.04 (0.95–1.14), 0.96 (0.90–1.04), 1.11 (1.02–1.20), and 1.28 (1.14–1.45) in women, respectively. Poor subjective sleep quality was associated with glomerular hyperfiltration in men and women. Conclusion In this large study of young and middle-aged adults, we found that long sleep duration was associated with CKD and glomerular hyperfiltration. Additionally, poor subjective sleep quality was associated with increased prevalence of glomerular hyperfiltration, suggesting the importance of adequate quantity and quality of sleep for kidney function.
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Affiliation(s)
- Chan-Won Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Eunju Sung
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung Eun Yun
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyun-Suk Jung
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byung-Joon Ko
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Min-Jung Kwon
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Youl Hyun
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyu-Beck Lee
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyang Kim
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hocheol Shin
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- * E-mail:
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Cheungpasitporn W, Thongprayoon C, Srivali N, Vijayvargiya P, Andersen CA, Kittanamongkolchai W, Sathick IJJ, Caples SM, Erickson SB. The effects of napping on the risk of hypertension: a systematic review and meta-analysis. J Evid Based Med 2016; 9:205-212. [PMID: 27376587 DOI: 10.1111/jebm.12211] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 06/23/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The risk of hypertension in adults who regularly take a nap is controversial. The objective of this meta-analysis was to assess the associations between napping and hypertension. METHODS A literature search was performed using MEDLINE, EMbase and The Cochrane Database of Systematic Reviews from inception through October, 2015. Studies that reported relative risks, odd ratios or hazard ratios comparing the risk of hypertension in individuals who regularly take nap were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. RESULTS Nine observational studies with 112,267 individuals were included in the analysis to assess the risk of hypertension in nappers. The pooled RR of hypertension in nappers was 1.13 with 95% CI (0.98 to 1.30). When meta-analysis was limited only to studies assessing the risk of hypertension in daytime nappers, the pooled RR of hypertension was 1.19 with 95% CI (1.06 to 1.35). The data on association between nighttime napping in individuals who work night shift and hypertension were limited, only one observational study reported reduced risk of hypertension in nighttime nappers with odds ratio of 0.79 with 95% CI (0.63 to 1.00). CONCLUSIONS Our meta-analysis demonstrates a significant association between daytime napping and hypertension. Future study is needed to assess the potential benefits of HTN screening for daytime nappers.
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Affiliation(s)
| | | | - Narat Srivali
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Carl A Andersen
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Sean M Caples
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Stephen B Erickson
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
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