Sleep quality, autonomic dysfunction and renal function in diabetic patients with pre-CKD phase

Abstract Diabetes has been established as a strong risk factor for chronic kidney disease (CKD). Sleep apnea, poor sleep quality (PSQ), and autonomic imbalance are also considered to be potential risk factors for decline in renal function, though no known study has examined their integrated predicti...

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Autores principales:	Manabu Kadoya, Akiko Morimoto, Akio Miyoshi, Miki Kakutani-Hatayama, Kae Kosaka-Hamamoto, Kosuke Konishi, Yoshiki Kusunoki, Takuhito Shoji, Hidenori Koyama
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4c4becca43fb48cf8ce779b58c24d789
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spelling	oai:doaj.org-article:4c4becca43fb48cf8ce779b58c24d7892021-12-02T18:14:39ZSleep quality, autonomic dysfunction and renal function in diabetic patients with pre-CKD phase10.1038/s41598-021-98505-82045-2322https://doaj.org/article/4c4becca43fb48cf8ce779b58c24d7892021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98505-8https://doaj.org/toc/2045-2322Abstract Diabetes has been established as a strong risk factor for chronic kidney disease (CKD). Sleep apnea, poor sleep quality (PSQ), and autonomic imbalance are also considered to be potential risk factors for decline in renal function, though no known study has examined their integrated predictive value in diabetic and non-diabetic patients without CKD. The present cohort consisted of 754 serial patients (diabetes; n = 231, non-diabetes; n = 523) without CKD registered in the Hyogo Sleep Cardio-Autonomic Atherosclerosis (HSCAA) study. Patients underwent examinations to determine respiratory event index and objective sleep quality using actigraphy, as well as heart rate variability (HRV). Renal outcome was defined as a decline in estimated glomerular filtration rate to less than 60 ml/min/1.73 m2 for more than 3 months. Kaplan–Meier analysis showed that diabetic patients with PSQ or low HRV, but not sleep apnea, had a significantly increased risk for renal outcome. Furthermore, Cox proportional hazards analysis revealed that PSQ was significantly associated with elevated risk of renal outcome (HR: 2.57; 95% CI: 1.01–6.53, p = 0.045) independent of sleep apnea and classical risk factors. Low HRV tended to be, but not significantly (p = 0.065), associated with the outcome. In non-diabetic patients, PSQ was also significantly and independently associated with renal outcome, whereas sleep apnea and low HRV were not. In conclusion, PSQ and low HRV appear to be important predictors of decline in renal function in diabetic patients without CKD.Manabu KadoyaAkiko MorimotoAkio MiyoshiMiki Kakutani-HatayamaKae Kosaka-HamamotoKosuke KonishiYoshiki KusunokiTakuhito ShojiHidenori KoyamaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Manabu Kadoya Akiko Morimoto Akio Miyoshi Miki Kakutani-Hatayama Kae Kosaka-Hamamoto Kosuke Konishi Yoshiki Kusunoki Takuhito Shoji Hidenori Koyama Sleep quality, autonomic dysfunction and renal function in diabetic patients with pre-CKD phase
description	Abstract Diabetes has been established as a strong risk factor for chronic kidney disease (CKD). Sleep apnea, poor sleep quality (PSQ), and autonomic imbalance are also considered to be potential risk factors for decline in renal function, though no known study has examined their integrated predictive value in diabetic and non-diabetic patients without CKD. The present cohort consisted of 754 serial patients (diabetes; n = 231, non-diabetes; n = 523) without CKD registered in the Hyogo Sleep Cardio-Autonomic Atherosclerosis (HSCAA) study. Patients underwent examinations to determine respiratory event index and objective sleep quality using actigraphy, as well as heart rate variability (HRV). Renal outcome was defined as a decline in estimated glomerular filtration rate to less than 60 ml/min/1.73 m2 for more than 3 months. Kaplan–Meier analysis showed that diabetic patients with PSQ or low HRV, but not sleep apnea, had a significantly increased risk for renal outcome. Furthermore, Cox proportional hazards analysis revealed that PSQ was significantly associated with elevated risk of renal outcome (HR: 2.57; 95% CI: 1.01–6.53, p = 0.045) independent of sleep apnea and classical risk factors. Low HRV tended to be, but not significantly (p = 0.065), associated with the outcome. In non-diabetic patients, PSQ was also significantly and independently associated with renal outcome, whereas sleep apnea and low HRV were not. In conclusion, PSQ and low HRV appear to be important predictors of decline in renal function in diabetic patients without CKD.
format	article
author	Manabu Kadoya Akiko Morimoto Akio Miyoshi Miki Kakutani-Hatayama Kae Kosaka-Hamamoto Kosuke Konishi Yoshiki Kusunoki Takuhito Shoji Hidenori Koyama
author_facet	Manabu Kadoya Akiko Morimoto Akio Miyoshi Miki Kakutani-Hatayama Kae Kosaka-Hamamoto Kosuke Konishi Yoshiki Kusunoki Takuhito Shoji Hidenori Koyama
author_sort	Manabu Kadoya
title	Sleep quality, autonomic dysfunction and renal function in diabetic patients with pre-CKD phase
title_short	Sleep quality, autonomic dysfunction and renal function in diabetic patients with pre-CKD phase
title_full	Sleep quality, autonomic dysfunction and renal function in diabetic patients with pre-CKD phase
title_fullStr	Sleep quality, autonomic dysfunction and renal function in diabetic patients with pre-CKD phase
title_full_unstemmed	Sleep quality, autonomic dysfunction and renal function in diabetic patients with pre-CKD phase
title_sort	sleep quality, autonomic dysfunction and renal function in diabetic patients with pre-ckd phase
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4c4becca43fb48cf8ce779b58c24d789
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Sleep quality, autonomic dysfunction and renal function in diabetic patients with pre-CKD phase

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