Abstract
BackgroundPoor sleep quality, a novel risk factor of cardiovascular diseases (CVD), is highly prevalent in patients with chronic kidney disease (CKD). The association between poor sleep quality and cardiovascular damage in patients with CKD is unclear. This study is aimed to assess the prevalence and related risk factors of sleep disturbance and determine the relationship between sleep quality and cardiovascular damage in Chinese patients with pre-dialysis CKD.MethodsA total of 427 pre-dialysis CKD patients (mean age = 39 ± 15 years, 260 male/167 female) were recruited in this study. The demographics and clinical correlates were collected. The sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI), whereas the cardiovascular damage indicators (the Early/late diastolic peak flow velocity (E/A) ratio and left ventricular mass index (LVMI)) were determined by an echocardiographic examination.ResultsOf the CKD patients, 77.8% were poor sleepers as defined by a PSQI score > 5. Median estimated glomerular filtration rate (eGFR) was 69.4(15.8-110.9) ml/min/1.73 m2. Logistic regression analysis revealed that left ventricular hypertrophy (LVH) was independently associated with the PSQI score (OR = 1.092, 95% CI = 1.011-1.179, p = 0.025), after adjustment for age, sex and clinical systolic blood pressure, diastolic blood pressure, Phosphate, Intact parathyroid hormone (iPTH), Hemoglobin and eGFR. The linear regression analysis showed that the E/A ratios were independently associated with the PSQI score (β = -0.115, P = 0.028) after adjustment for a series of potential confounding factors.ConclusionsPoor sleep quality, which is commonly found in pre-dialysis CKD patients, is an independent factor associated with cardiovascular damage in CKD patients. Our finding implies that the association between poor sleep and CVD might be mediated by cardiac remodeling.
Highlights
Poor sleep quality, a novel risk factor of cardiovascular diseases (CVD), is highly prevalent in patients with chronic kidney disease (CKD)
A total of 498 patients were diagnosed with CKD: 10 patients were treated with corticosteroids or hormones, 5 patients were < 18 years old, 6 patients had an acute estimated glomerular filtration rate (eGFR) decrease, 8 patients had acute cardiovascular disorders, 9 patients had an infection, 12 patients were in renal replacement therapy and 3 patients had shift work employment, and these patients were excluded according to the exclusion criteria
A total of 332 patients (77.8%) had poor sleep quality as defined as a Pittsburgh Sleep Quality Index (PSQI) score > 5
Summary
A novel risk factor of cardiovascular diseases (CVD), is highly prevalent in patients with chronic kidney disease (CKD). The association between poor sleep quality and cardiovascular damage in patients with CKD is unclear. This study is aimed to assess the prevalence and related risk factors of sleep disturbance and determine the relationship between sleep quality and cardiovascular damage in Chinese patients with pre-dialysis CKD. Recent studies have shown that poor sleep quality was related to the progression of cardiovascular disease (CVD) [5,6]. Few studies have examined sleep problems in the considerably larger group of patients with pre-dialysis CKD, and the related factors of poor sleep quality are not clear in these populations. Further research with a larger sample size and a different study population is needed
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