title: Objective sleep, a novel risk factor for alterations in kidney function: the CARDIA study.
abstract: OBJECTIVE
  To determine the association between objectively measured sleep and 10-year changes in estimated glomerular filtration rate (eGFR).
  
  
  METHODS
  From 2003 to 2005, an ancillary sleep study was conducted at the Chicago site of the Coronary Artery Risk Development in Young Adults (CARDIA) study. Community-based black and white adults (aged 32-51 years) wore a wrist actigraph for up to six nights to record sleep duration and fragmentation. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Participants without history of cardiovascular or chronic kidney diseases, proteinuria, or hypertension at the 2000-2001 CARDIA examination were followed over 10 years (n = 463). eGFR was estimated from serum creatinine (eGFRCr) at the 2000-2001, 2005-2006, and 2010-2011 CARDIA examinations, whereas cystatin-C-estimated eGFR (eGFRCys) was measured at the 2000-2001 and 2005-2006 examinations. Generalized estimating equation regression and linear models estimated the associations of each sleep parameter with changes in eGFRCr and eGFRCys, controlling for cardiovascular and renal risk.
  
  
  RESULTS
  Sleep parameters were not related to 5-year change in eGFRCys. However, each 1 h decrease in sleep duration was significantly associated with a 1.5 mL/min/1.73 m2 higher eGFRCr [95% confidence interval (CI), 0.2-2.7], and each one-point increase in PSQI was significantly associated with a 0.5 mL/min/1.73 m2 higher eGFRCr (95% CI, 0.04-0.9) over 10 years.
  
  
  CONCLUSIONS
  In this community-based sample, shorter sleep and poorer sleep quality were related to higher kidney filtration rates over 10 years.
authors.affiliation: College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA. Electronic address: megan.petrov@asu.edu.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Petrov
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Yongin
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA.
authors.forename: Diane S
authors.initials: DS
authors.lastname: Lauderdale
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.affiliation: Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
authors.forename: Jared P
authors.initials: JP
authors.lastname: Reis
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Mercedes R
authors.initials: MR
authors.lastname: Carnethon
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA.
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Knutson
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Glasser
mesh_terms: D056044:Actigraphy; D000328:Adult; D002641:Chicago; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012307:Risk Factors; D012890:Sleep / Q000502:physiology*; D012892:Sleep Deprivation / Q000503:physiopathology*
keywords: Glomerular filtration rate; Kidney function; Objective sleep; Race; Sex; Sleep duration; Sleep quality