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短睡眠时间对蛋白尿和慢性肾脏病的影响:系统评价和荟萃分析。

The effects of short sleep duration on proteinuria and chronic kidney disease: a systematic review and meta-analysis.

机构信息

Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA.

Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.

出版信息

Nephrol Dial Transplant. 2017 Jun 1;32(6):991-996. doi: 10.1093/ndt/gfw072.

Abstract

BACKGROUND

The risks of proteinuria and chronic kidney disease (CKD) in adults who regularly have short sleep duration (short sleepers) are controversial. The aim of this meta-analysis was to assess the effects of short sleep duration on proteinuria and CKD.

METHODS

A literature search was conducted using MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews from the inception of the databases through November 2015. Studies that reported relative risks, odd ratios or hazard ratios comparing the risks of proteinuria and CKD in short sleepers were included. Pooled risk ratios (RR) and 95% confidence intervals (CI) were computed utilizing a random-effect, generic inverse variance method.

RESULTS

Six observational studies with 252 075 individuals and three observational studies with 37 197 individuals were included in the analyses to assess the risks of CKD and proteinuria in short sleepers, respectively. The pooled RR of CKD in short sleepers was 1.51 (95% CI, 0.99-2.55). When meta-analysis was restricted only to studies with adjusted analysis for confounders assessing the risk of CKD in short sleepers, the pooled RR of CKD was 1.54 (95% CI, 0.80-2.95). The pooled RR of proteinuria in short sleepers was 1.47 (95% CI, 1.26-1.72).

CONCLUSIONS

Despite the lack of significant association between short sleep duration and CKD, our meta-analysis suggests a potential association between short sleep duration and proteinuria, a surrogate marker for kidney disease progression. Future study is required to investigate if reversal of short sleep helps reduce proteinuria.

摘要

背景

经常睡眠不足(短睡者)的成年人发生蛋白尿和慢性肾病(CKD)的风险存在争议。本荟萃分析的目的是评估短睡眠时间对蛋白尿和 CKD 的影响。

方法

通过检索 MEDLINE、EMBASE 和 Cochrane 系统评价数据库,从建库开始至 2015 年 11 月,检索比较短睡者蛋白尿和 CKD 风险的相关文献。纳入报告相对风险、比值比或危险比的观察性研究。采用随机效应、通用倒数方差法计算汇总风险比(RR)和 95%置信区间(CI)。

结果

纳入 6 项观察性研究,共 252075 例患者,3 项观察性研究,共 37197 例患者,分别分析短睡者发生 CKD 和蛋白尿的风险。短睡者发生 CKD 的汇总 RR 为 1.51(95%CI,0.99-2.55)。当限定仅纳入对 CKD 风险进行调整分析的混杂因素的研究时,短睡者发生 CKD 的汇总 RR 为 1.54(95%CI,0.80-2.95)。短睡者发生蛋白尿的汇总 RR 为 1.47(95%CI,1.26-1.72)。

结论

尽管短睡眠时间与 CKD 之间无显著关联,但本荟萃分析提示短睡眠时间与蛋白尿之间存在潜在关联,而蛋白尿是肾脏疾病进展的替代标志物。需要进一步研究以明确纠正短睡眠时间是否有助于减少蛋白尿。

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