Relationship between trajectory of sleep quality and short-term changes in residual renal function in stage 3-5 chronic kidney disease patients.

Background: Chronic kidney disease (CKD) is commonly associated with sleep disturbance. However, the relationship between the trajectory of sleep quality and short-term residual renal function is not clear. Thus, this study aimed to investigate such relationship.

Methods: In total, 132 patients with CKD stage 3-5 were prospectively enrolled. All participants were followed-up for 6 months. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. The longitudinal PSQI and estimated glomerular filtration rate (eGFR) were measured at baseline, the 3rd month and 6th month. The participants were stratified into three groups according to the PSQI trajectories. The primary outcome was set as the eGFR change among 6 months less than the median.

Results: Sixty nine participants showed PSQI ≤ 5 at baseline and 15 patients had increased scores > 5 at 3rd month among them. 63 participants showed PSQI > 5 at baseline and 11 patients had decreased scores ≤ 5 at 3rd month. Only in patients whose baseline PSQI ≤ 5 but increased to > 5 at 3rd month presented a longitudinal decline in eGFR at both 3rd month and 6th month compared with baseline eGFR. Linear regression analysis for eGFR change showed no significant association between eGFR change and PSQI score. Logistic regression revealed worsen sleep quality will deteriorate renal function.

Conclusion: A relationship was observed between worsening sleep quality and eGFR decline in non-dialysis CKD patients.