Association between sleep quality and cardiovascular damage in pre-dialysis patients with chronic kidney disease

BMC Nephrology

Tanqi Lou¹  Zengchun Ye¹  Wenbo Zhao¹  Cui Cui Li¹  Ying Tang²  Hui Peng¹  Wenyu Gong¹  Cheng Wang¹  Jun Zhang¹ 

[1] Division of Nephrology, Department of Medicine, 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong, China;Division of Nephrology, Department of Medicine, 2rd Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, Guangdong, China

关键词: Left ventricular hypertrophy (LVH);    Cardiovascular damage;    Chronic kidney disease;    Pittsburgh Sleep Quality Index (PSQI);    Sleep quality;   

Others  :  1082642
DOI  :  10.1186/1471-2369-15-131

 received in 2014-04-03, accepted in 2014-08-05,  发布年份 2014

【 摘 要 】

Background

Poor sleep quality, a novel risk factor of cardiovascular diseases (CVD), is highly prevalent in patients with chronic kidney disease (CKD). The association between poor sleep quality and cardiovascular damage in patients with CKD is unclear. This study is aimed to assess the prevalence and related risk factors of sleep disturbance and determine the relationship between sleep quality and cardiovascular damage in Chinese patients with pre-dialysis CKD.

Methods

A total of 427 pre-dialysis CKD patients (mean age = 39 ± 15 years, 260 male/167 female) were recruited in this study. The demographics and clinical correlates were collected. The sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI), whereas the cardiovascular damage indicators (the Early/late diastolic peak flow velocity (E/A) ratio and left ventricular mass index (LVMI)) were determined by an echocardiographic examination.

Results

Of the CKD patients, 77.8% were poor sleepers as defined by a PSQI score > 5. Median estimated glomerular filtration rate (eGFR) was 69.4(15.8-110.9) ml/min/1.73 m². Logistic regression analysis revealed that left ventricular hypertrophy (LVH) was independently associated with the PSQI score (OR = 1.092, 95% CI = 1.011-1.179, p = 0.025), after adjustment for age, sex and clinical systolic blood pressure, diastolic blood pressure, Phosphate, Intact parathyroid hormone (iPTH), Hemoglobin and eGFR. The linear regression analysis showed that the E/A ratios were independently associated with the PSQI score (β = -0.115, P = 0.028) after adjustment for a series of potential confounding factors.

Conclusions

Poor sleep quality, which is commonly found in pre-dialysis CKD patients, is an independent factor associated with cardiovascular damage in CKD patients. Our finding implies that the association between poor sleep and CVD might be mediated by cardiac remodeling.

【 授权许可】

   
2014 Zhang et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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