title: Association between sleep quality and cardiovascular damage in pre-dialysis patients with chronic kidney disease.
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 m(2). 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.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Wenyu
authors.initials: W
authors.lastname: Gong
authors.forename: Hui
authors.initials: H
authors.lastname: Peng
authors.forename: Ying
authors.initials: Y
authors.lastname: Tang
authors.forename: Cui Cui
authors.initials: CC
authors.lastname: Li
authors.forename: Wenbo
authors.initials: W
authors.lastname: Zhao
authors.forename: Zengchun
authors.initials: Z
authors.lastname: Ye
authors.affiliation: Division of Nephrology, Department of Medicine, 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong, China. lou.tq@163.com.
authors.forename: Tanqi
authors.initials: T
authors.lastname: Lou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D055815:Young Adult