Edalat-Nejad Mahnaz, Jafarian Nahid, Yousefichaijan Parsa
Internal Medicine Department, Nephrology Ward, Arak Medical Sciences University, Arak, Iran.
Saudi J Kidney Dis Transpl. 2014 Jul;25(4):774-80. doi: 10.4103/1319-2442.134994.
Sleep complaints are common in hemodialysis (HD) patients. Sleep quality (SQ) is a predictor of quality of life and mortality risk in HD. The aim of this study was to examine factors that may have a role in SQ. In this cross-sectional analytic study, 138 end-stage renal disease patients receiving maintenance HD for >3 months were included. The Pittsburgh Sleep Quality Index (PSQI) was used to measure individual's SQ. Patients with a global PSQI score >5 were assumed as poor sleepers. Eighty-eight patients (64%) were classified as poor sleepers. Poor sleepers were older and more likely had diabetes. They had significantly higher serum ferritin and calcium levels and lower serum parathyroid hormone level (all P-values <0.05). The global PSQI score was positively correlated with age, serum calcium level and presence of diabetes as the underlying cause of renal failure. In the multi-variable binary regression model, presence of diabetes (Odds Ratio (OR) = 3.67, P = 0.008) and body pain (OR = 1.182, P = 0.014) were the significant independent predictors for poor SQ. Poor SQ was common among our HD patients, especially among diabetic cases and, therefore, there is a need to pay more attention to the care of this subgroup with regard to the diagnosis and management of sleep complaints.
睡眠问题在血液透析（HD）患者中很常见。睡眠质量（SQ）是HD患者生活质量和死亡风险的一个预测指标。本研究的目的是探讨可能影响SQ的因素。在这项横断面分析研究中，纳入了138例接受维持性HD治疗超过3个月的终末期肾病患者。采用匹兹堡睡眠质量指数（PSQI）来测量个体的SQ。PSQI总分>5分的患者被视为睡眠不佳者。88例患者（64%）被归类为睡眠不佳者。睡眠不佳者年龄较大，更易患糖尿病。他们的血清铁蛋白和钙水平显著更高，而血清甲状旁腺激素水平更低（所有P值<0.05）。PSQI总分与年龄、血清钙水平以及作为肾衰竭潜在病因的糖尿病的存在呈正相关。在多变量二元回归模型中，糖尿病的存在（比值比（OR）=3.67，P=0.008）和身体疼痛（OR=1.182，P=0.014）是SQ不佳的显著独立预测因素。SQ不佳在我们的HD患者中很常见，尤其是在糖尿病患者中，因此，在睡眠问题的诊断和管理方面，需要更加关注这一亚组患者的护理。
