title: Sleep and CKD in Chinese Adults: A Cross-Sectional Study.
abstract: OBJECTIVE
  To assess the association between self-reported sleep duration and quality and odds of having CKD in Chinese adults on the basis of a community study.
  
  
  METHODS
  In this cross-sectional study, we included 11,040 Chinese adults who participated in an ongoing prospective study, the Kailuan cohort. Survey questionnaire items addressed insomnia, daytime sleepiness, snoring, and sleep duration during their 2012 interview. Overall sleep quality was evaluated by summarizing these four sleep parameters. Fasting blood samples and single random midstream morning urine samples were collected in 2012 and analyzed for serum creatinine and proteinuria. CKD was defined by eGFR<60 ml/min per 1.73 m2or proteinuria >300 mg/dl. We also examined those at high or very high risk of having CKD, on the basis of the Kidney Disease Improving Global Outcomes recommendations. The association between sleep quality and CKD was assessed using logistic regression model.
  
  
  RESULTS
  Worse overall sleep quality was associated with higher likelihood of being high or very high risk for CKD (multiadjusted odds ratio, 2.69; 95% confidence interval, 1.30 to 5.59 comparing two extreme categories;Ptrend <0.01), but not overall CKD (multiadjusted odds ratio, 1.58; 95% confidence interval, 0.89 to 2.80 comparing two extreme categories;Ptrend =0.46), after adjusting for potential confounders. Specifically, individuals with worse sleep quality were more likely to have proteinuria (multiadjusted odds ratio, 1.95; 95% confidence interval, 1.03 to 3.67 comparing two extreme categories;Ptrend =0.02), rather than lower eGFR level (multiadjusted mean eGFR levels were 96.4 and 93.6 ml/min per 1.73 m2in the two extreme sleep categories, respectively;Ptrend =0.13). However, there was no statistically significant association between individual sleep parameters and CKD status.
  
  
  CONCLUSIONS
  Worse overall sleep quality was associated with higher odds of being high or very high risk for CKD and proteinuria in Chinese adults.
authors.affiliation: Departments of Nephrology and.
authors.forename: Junjuan
authors.initials: J
authors.lastname: Li
authors.affiliation: Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Departments of Nephrology and.
authors.forename: Jinhong
authors.initials: J
authors.lastname: Hou
authors.affiliation: College of Nursing and.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Sawyer
authors.affiliation: Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Nephrology and.|Clinical Epidemiology Unit, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing, China; and.
authors.forename: Jianfang
authors.initials: J
authors.lastname: Cai
authors.affiliation: The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Gary
authors.initials: G
authors.lastname: Curhan
authors.affiliation: Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, China.
authors.forename: Shouling
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Nutritional Science, The Pennsylvania State University, State College, Pennsylvania.
authors.forename: Xiang
authors.initials: X
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D011507:Proteinuria / Q000453:epidemiology; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D057566:Self Report; D012890:Sleep; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013997:Time Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine
keywords: Adult; Cross-Sectional Studies; Fasting; Humans; Kidney Function Tests; Logistic Models; Prospective Studies; Renal Insufficiency, Chronic; Self Report; Sleep; Sleep Initiation and Maintenance Disorders; Snoring; Surveys and Questionnaires; chronic kidney disease; creatinine; cross-sectional study; glomerular filtration rate; proteinuria