title: Sleep quality and risk factors of atherosclerosis in predialysis chronic kidney disease.
abstract: BACKGROUND
  Chronic kidney disease (CKD) patients have more frequent sleep disorders and cardiovascular disease than normals. Since arterial stiffness as a risk factor of atherosclerosis can be evaluated with pulse wave velocity (PWV), we aimed to investigate the prevalance of sleep quality (SQ) and the relationship between SQ and risk factors of atherosclerosis and whether there is a relationship between SQ and PWV (the indicator of arterial stiffness) in predialysis CKD patients.
  
  
  METHODS
  This cross-sectional study was carried out in CKD patients followed at the Nephrology Department in Konya, Turkey, between November 2014 and March 2015. A total of 484 CKD patients were screened. Of the 484 patients, 285 patients were excluded. The remaining 199 CKD patients without cardiovascular disease at stage 3, 4, and 5 (predialysis) were included in the final study. The SQ of the patients was evaluated by the Pittsburgh Sleep Quality Index (PSQI). PWV was measured by using a single-cuff arteriography device (Mobil-O-Graph PWA, a model pulse wave analysis device; IEM).
  
  
  RESULTS
  A total of 199 predialysis CKD patients were included in the study, 73 of whom (36.7 %) were 'poor sleepers' (global PSQI &gt;5). Patients with poor SQ were older than those with good SQ (p = 0.077). SQ was worse in female patients compered to male patients (p = 0.001). SQ was worse in obese patients. As laboratory parameters, serum phosphorus, LDL cholesterol, and triglycerides levels correlated positively with SQ (respectively; r = 0.245, p&amp;0.001; r = 0.142, p = 0.049; r = 0.142, p = 0.048). The indicator of arterial stiffness, PWV, was higher in patients with poor SQ (p = 0.033). Hyperphosphatemia and female gender are determined as risk factors for poor SQ in multivariate analysis (p = 0.049, ExpB = 1.477; p = 0.009, ExpB = 0,429, respectively).
  
  
  CONCLUSIONS
  Our study showed for the first time that there is a relationship between SQ and risk factors of atherosclerosis in predialysis CKD patients.
authors.affiliation: Konya Research and Training Hospital, Nephrology Department, Konya - Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Guney
authors.affiliation: Konya Research and Training Hospital, Internal Medicine Department, Konya - Turkey.
authors.forename: Yavuz S S
authors.initials: YS
authors.lastname: Akgul
authors.affiliation: Konya Research and Training Hospital, Nephrology Department, Konya - Turkey.
authors.forename: Vedat
authors.initials: V
authors.lastname: Gencer
authors.affiliation: Konya Research and Training Hospital, Internal Medicine Department, Konya - Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Aydemir
authors.affiliation: Konya Research and Training Hospital, Internal Medicine Department, Konya - Turkey.
authors.forename: Uysaler
authors.initials: U
authors.lastname: Aslan
authors.affiliation: Konya Research and Training Hospital, Internal Medicine Department, Konya - Turkey.
authors.forename: Samil
authors.initials: S
authors.lastname: Ecirli
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D054559:Hyperphosphatemia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D014421:Turkey / Q000453:epidemiology; D059289:Vascular Stiffness; D055815:Young Adult