title: Impact of sleep disturbances on kidney function decline in the elderly.
abstract: While sleep disturbances are frequent in renal disease patients, no studies have examined prospectively the associations between sleep disturbances and kidney function decline in community-dwelling elderly subjects.Glomerular filtration rates (eGFRs) were estimated at baseline and at 11-year follow-up. A glomerular filtration decline over the follow-up period was defined as a percentage decline greater than or equal to the cut-off value of the highest tertile of kidney function decline (22%) in 1105 subjects. Excessive daytime sleepiness (EDS) and insomnia complaints were self-rated at baseline. Restless legs syndrome (RLS) and its age at onset were assessed at study end-point. An ambulatory polysomnography recording was performed during the follow-up in 277 subjects. Apnoea-hypopnoea index (AHI), periodic limb movements during sleep (PLMS) and total sleep time were analysed.An increased risk of eGFR decline was associated with EDS (OR 1.67, 95% CI 1.18-2.34) and RLS (OR 1.98, 95% CI 1.18-3.30) independently of potential confounders including cardiovascular risk factors. Among insomnia complaints, a borderline association with eGFR decline was found for early morning awakening only. High AHI (≥30 events·h(-1)) and short total sleep time (<6 h), but not PLMS were linked to eGFR decline in crude associations, but only AHI remained significantly associated after multi-adjustments.EDS, RLS and AHI constitute independent risk factors for kidney glomerular function decline.
authors.affiliation: Inserm, U1061, Montpellier, France Université Montpellier, Montpellier, France isabelle.jaussent@inserm.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaussent
authors.affiliation: Université Montpellier, Montpellier, France Laboratoire de Biochimie, CHRU de Montpellier, Montpellier, France Inserm, U1046, CNRS UMR 9214, Montpellier, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Cristol
authors.affiliation: Inserm U1018, Team 5, Villejuif, France Université Paris-Sud, Villejuif, France Université Versailles-Saint-Quentin, France.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Stengel
authors.affiliation: Inserm, U1061, Montpellier, France Université Montpellier, Montpellier, France.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Ancelin
authors.affiliation: Inserm, U1061, Montpellier, France Université Montpellier, Montpellier, France Laboratoire de Biochimie, CHRU de Montpellier, Montpellier, France.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Dupuy
authors.affiliation: Inserm, U1061, Montpellier, France Université Montpellier, Montpellier, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Besset
authors.affiliation: Inserm, U897, Bordeaux, France Université de Bordeaux, ISPED, Bordeaux, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Helmer
authors.affiliation: Inserm, U1061, Montpellier, France Université Montpellier, Montpellier, France Faculty of Medicine, Imperial College, London, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.affiliation: Inserm, U1061, Montpellier, France Université Montpellier, Montpellier, France.
authors.forename: Claudine
authors.initials: C
authors.lastname: Berr
authors.affiliation: Inserm, U1061, Montpellier, France Université Montpellier, Montpellier, France Service de Neurologie, Unité des Troubles du Sommeil, CHU Montpellier, Hôpital Gui-de-Chauliac, Montpellier, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Dauvilliers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D017286:Polysomnography; D011446:Prospective Studies; D012148:Restless Legs Syndrome / Q000453:epidemiology*; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*