Department of Internal Medicine, Korea University Anam Hospital, Seoul 02841, Korea.
Department of Biostatistics, Korea University College of Medicine, Seoul 02842, Korea.
Int J Environ Res Public Health. 2022 May 8;19(9):5732. doi: 10.3390/ijerph19095732.
Disturbances in circadian rhythms cause several health problems, such as psychosis, metabolic syndrome, and cancer; however, their effect on kidney disease remains unclear. This study aimed to evaluate the association between chronic kidney disease (CKD) and sleep disturbance in a Korean adult population. A total of 17,408 participants who completed the National Health and Nutrition Examination Survey from 2016 to 2018 were assessed for their sleep patterns and renal function. CKD was defined as an estimated glomerular filtration rate ≤ 60 mL/min/1.73 m² or a positive dipstick urinalysis. Sleep onset time and sleep duration showed significant differences between the control and CKD groups (p < 0.001). After adjusting for the covariates, sleep onset time rather than sleep duration was independently associated with incidence of CKD, and this association was more significant in people who were older, in women, and in those with low body mass index and no comorbidities. When comparing the prevalence of newly diagnosed CKD according to sleep onset time in a population with no CKD risk factors or no history of CKD, the early bedtime group showed an independent association with incidence of new CKD (odds ratio (OR), 1.535; 95% confidence interval (CI), 1.011−2.330) even after adjusting for covariates. Impaired circadian rhythm along with sleep disturbance could be associated with CKD development; therefore, sleep disturbance might be an important therapeutic target for CKD.
昼夜节律紊乱会导致多种健康问题,如精神病、代谢综合征和癌症;然而,其对肾脏疾病的影响尚不清楚。本研究旨在评估韩国成年人群中慢性肾脏病(CKD)与睡眠障碍之间的关系。共有 17408 名参与者完成了 2016 年至 2018 年的全国健康和营养调查,评估了他们的睡眠模式和肾功能。CKD 的定义为估算肾小球滤过率≤60ml/min/1.73m²或尿试纸呈阳性。睡眠潜伏期和睡眠时间在对照组和 CKD 组之间有显著差异(p<0.001)。在调整了混杂因素后,睡眠潜伏期而不是睡眠时间与 CKD 的发生独立相关,这种相关性在年龄较大、女性、体重指数较低且无合并症的人群中更为显著。当比较无 CKD 风险因素或无 CKD 病史的人群中根据睡眠潜伏期出现的新诊断 CKD 的患病率时,早睡组与新 CKD 的发生呈独立相关(比值比(OR),1.535;95%置信区间(CI),1.011−2.330),即使在调整了混杂因素后也是如此。昼夜节律紊乱和睡眠障碍可能与 CKD 的发展有关;因此,睡眠障碍可能是 CKD 的一个重要治疗靶点。