Email updates

Keep up to date with the latest news and content from BMC Nephrology and BioMed Central.

Open Access Highly Accessed Research article

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

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

  • * Corresponding author: Tanqi Lou lou.tq@163.com

  • † Equal contributors

Author Affiliations

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

2 Division of Nephrology, Department of Medicine, 2rd Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, Guangdong, China

For all author emails, please log on.

BMC Nephrology 2014, 15:131  doi:10.1186/1471-2369-15-131

Published: 12 August 2014

Abstract

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.

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