Cardiometabolic traits mediate the association of past shift work and chronic kidney disease: the Dongfeng-Tongji cohort study.

Abstract

Present shift work has been associated with chronic disease. But influence of past shift work has not been established. This study is designed to investigate whether shift work in the past is associated with chronic kidney disease (CKD) in retired workers, and whether cardiometabolic traits affect the relationship. Overall, 15,775 retired workers (aged 62.3 ± 7.2years) without CKD at baseline in the Dongfeng-Tongji cohort were included. Duration of past shift work was obtained through questionnaires, and divided into < 10.0, 10.0-20.0, and ≥ 20.0years. CKD was diagnosed if individual's estimated glomerular filtration rate (eGFR) < 60mL/min/1.73m2. Logistic regression model was used to estimate the association between past shift work and CKD. Mediation analysis was conducted to analyze the mediating effects of cardiometabolic traits. During the median follow-up of 4.7years, 1072 (6.8%) incident CKD cases were recorded. Retired workers with past shift work had elevated CKD risk [ORs and 95% CIs for those with < 10.0, 10.0-20.0, and ≥ 20.0years of past shift work were 1.61 (1.30, 2.00), 0.90 (0.72, 1.12), and 1.33 (1.11, 1.61)]. The associations were more evident among participants with poor or terrible sleep quality (P for interaction, 0.022). Mediation analysis showed that cardiometabolic traits including diastolic blood pressure and high density lipoprotein cholesterol mediated 7.02% and 10.05% of the relationship from past shift work to higher CKD risk. Past shift work was related with increased risk of incident CKD among retired workers, and this relationship was partly mediated by cardiometabolic traits.