Department of Nephrology, Tianjin First Center Hospital, Nankai District, No. 24 Fukang Road, Tianjin, 300192, China.
Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Rd, Niao Song, District, Gaoxiong, 833, Taiwan.
Clin Exp Nephrol. 2020 Jun;24(6):557-564. doi: 10.1007/s10157-020-01868-x. Epub 2020 Mar 14.
Chronic kidney disease (CKD) is commonly associated with sleep disturbance. However, the relationship between the trajectory of sleep quality and short-term residual renal function is not clear. Thus, this study aimed to investigate such relationship.
In total, 132 patients with CKD stage 3-5 were prospectively enrolled. All participants were followed-up for 6 months. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. The longitudinal PSQI and estimated glomerular filtration rate (eGFR) were measured at baseline, the 3rd month and 6th month. The participants were stratified into three groups according to the PSQI trajectories. The primary outcome was set as the eGFR change among 6 months less than the median.
Sixty nine participants showed PSQI ≤ 5 at baseline and 15 patients had increased scores > 5 at 3rd month among them. 63 participants showed PSQI > 5 at baseline and 11 patients had decreased scores ≤ 5 at 3rd month. Only in patients whose baseline PSQI ≤ 5 but increased to > 5 at 3rd month presented a longitudinal decline in eGFR at both 3rd month and 6th month compared with baseline eGFR. Linear regression analysis for eGFR change showed no significant association between eGFR change and PSQI score. Logistic regression revealed worsen sleep quality will deteriorate renal function.
A relationship was observed between worsening sleep quality and eGFR decline in non-dialysis CKD patients.
慢性肾脏病（CKD）常伴有睡眠障碍。然而，睡眠质量的轨迹与短期残余肾功能之间的关系尚不清楚。因此，本研究旨在探讨这种关系。
共前瞻性纳入 132 例 CKD 3-5 期患者。所有患者均随访 6 个月。采用匹兹堡睡眠质量指数（PSQI）问卷评估睡眠质量。基线、第 3 个月和第 6 个月测量纵向 PSQI 和估计肾小球滤过率（eGFR）。根据 PSQI 轨迹将参与者分为三组。主要结局设定为 6 个月内 eGFR 变化低于中位数。
69 名参与者基线 PSQI≤5，其中 15 名患者第 3 个月 PSQI 评分>5。63 名参与者基线 PSQI>5，其中 11 名患者第 3 个月 PSQI 评分≤5。只有基线 PSQI≤5 但在第 3 个月增加到>5 的患者在第 3 个月和第 6 个月的 eGFR 与基线 eGFR 相比呈现出纵向下降。eGFR 变化的线性回归分析显示，eGFR 变化与 PSQI 评分之间无显著相关性。逻辑回归显示，睡眠质量恶化会导致肾功能恶化。
在非透析 CKD 患者中，观察到睡眠质量恶化与 eGFR 下降之间存在关系。
