Shafi Salman T, Shafi Tahir
a Department of Nephrology , Sharif Medical and Dental College , Lahore , Pakistan.
Ren Fail. 2017 Nov;39(1):623-628. doi: 10.1080/0886022X.2017.1361836.
Few studies have compared quality of sleep between pre-dialysis chronic kidney disease (pre-dialysis CKD) patients and end-stage renal disease patients on dialysis (ESRD) and have found inconsistent results. Objective of this study is to compare quality of sleep between patients with pre-dialysis CKD and ESRD in a developing country. This study was conducted in an out-patient department and hemodialysis unit of a tertiary care facility. Patients included had either pre-dialysis CKD or ESRD. Assessment of quality of sleep was done using Pittsburgh sleep quality index (PSQI). A total of 152 patients were included in the study. Out of these patients, 79 (52%) had ESRD and 73 (48%) had pre-dialysis CKD. Median PSQI score was 6 (IQR 3-8.8). Poor sleep quality (PSQI ≥5) was present in 100 (65.8%) patients. Only hemoglobin (β = -0.39, p < .01), depression (β = 0.56, p < .01) and history of cardiovascular disease (β = 0.22, p < .01) were associated with PSQI global score in a multiple linear regression analysis. There was no significant association between ESRD vs. pre-dialysis CKD and PSQI global scores and no significant co-relation between eGFR and global PSQI score (r = -0.34, p value .80) in pre-dialysis CKD patients. Poor sleep quality is common in patients with CKD including hemodialysis patients in a developing country, which is independent of kidney function in non-dialysis patients. There is no difference in quality of sleep between pre-dialysis CKD and ESRD patients.
很少有研究比较透析前慢性肾脏病（pre-dialysis CKD）患者和透析终末期肾病（ESRD）患者的睡眠质量，结果并不一致。本研究的目的是比较发展中国家pre-dialysis CKD患者和ESRD患者的睡眠质量。本研究在一家三级医疗机构的门诊部和血液透析单元进行。纳入的患者为pre-dialysis CKD患者或ESRD患者。使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。共有152名患者纳入本研究。其中，79名（52%）为ESRD患者，73名（48%）为pre-dialysis CKD患者。PSQI中位数为6（四分位间距3 - 8.8）。100名（65.8%）患者存在睡眠质量差（PSQI≥5）。在多元线性回归分析中，只有血红蛋白（β = -0.39，p < 0.01）、抑郁（β = 0.56，p < 0.01）和心血管疾病史（β = 0.22，p < 0.01）与PSQI总分相关。ESRD与pre-dialysis CKD和PSQI总分之间无显著关联，pre-dialysis CKD患者的估算肾小球滤过率（eGFR）与PSQI总分之间也无显著相关性（r = -0.34，p值0.80）。在发展中国家，包括血液透析患者在内的CKD患者睡眠质量差很常见，这在非透析患者中与肾功能无关。pre-dialysis CKD患者和ESRD患者的睡眠质量没有差异。
