title: Self-assessed sleep quality in chronic kidney disease.
abstract: BACKGROUND
  Although sleep complaints are commonly reported in persons with end stage renal disease (ESRD), little is known about the prevalence of sleep complaints in chronic kidney disease (CKD), and the relation of sleep quality to the severity of kidney disease.
  
  
  METHODS
  We administered the Kidney Disease Quality of Life (KDQOL) sleep scale to 156 subjects, 78 with ESRD and 78 with CKD. Glomerular filtration rate (GFR) was estimated using the six variable Modification of Diet in Renal Disease (MDRD) equation and used to stratify subjects with CKD as mild-moderate (GFR >25 ml/min/1.73 m(2)) and advanced (GFR <25 ml/min/1.73 m(2)). We used multivariable linear regression to determine independent predictors of KDQOL sleep scale scores. Higher scores indicate higher self-reported quality of sleep.
  
  
  RESULTS
  Median scores on the KDQOL sleep scale were 59 (interquartile range 40-80) in subjects with ESRD and 69 (interquartile range 53-80) in subjects with CKD (P=0.04). Thirty-four percent of subjects with ESRD, 27% of subjects with advanced CKD, and 14% of subjects with mild to moderate CKD had sleep maintenance disturbances (P=0.05). Thirteen percent of subjects with ESRD, 11% of subjects with advanced CKD, and no subjects with mild-moderate CKD had complaints of daytime somnolence (P=0.03). There was no significant difference in the prevalence of sleep adequacy complaints in persons with ESRD versus CKD. In multivariable analyses, only age and ESRD status (vs. CKD) were significant predictors of lower KDQOL sleep scores. Among subjects with CKD, there was a significant direct association between estimated GFR and scores on the KDQOL sleep scale in non-African American subjects (P=0.01).
  
  
  CONCLUSIONS
  Sleep complaints are common in persons with CKD and ESRD and may be associated with the severity of kidney disease.
authors.affiliation: Division of Nephrology, Department of Medicine Research, Moffitt-Long Hospitals, UCSF-Mt. Zion Medical Center, University of California San Francisco, UCSF Laurel Heights Suite 430, 3333 California Street, San Francisco, CA 94118-1211, USA.
authors.forename: Manjula
authors.initials: M
authors.lastname: Kurella
authors.forename: Jennifer
authors.initials: J
authors.lastname: Luan
authors.forename: James P
authors.initials: JP
authors.lastname: Lash
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Chertow
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012647:Self-Assessment; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires