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Lin X, Lv J, Zhang S, Ma X, Zhang X, Wang C, Zhang T. Healthy Lifestyle Behaviors Attenuate the Effect of Poor Sleep Patterns on Chronic Kidney Disease Risk: A Prospective Study from the UK Biobank. Nutrients 2024; 16:4238. [PMID: 39683631 DOI: 10.3390/nu16234238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2024] [Revised: 12/02/2024] [Accepted: 12/06/2024] [Indexed: 12/18/2024] Open
Abstract
OBJECTIVES This study aimed to assess the impact of modifiable lifestyle behaviors on the association between sleep patterns and chronic kidney disease (CKD) risk. METHODS This study included 294,215 UK Biobank participants initially without CKD, followed until 13 October 2023. Sleep patterns were derived from five sleep factors, including sleep duration, chronotype, insomnia, snoring, and daytime dozing. The healthy lifestyle score (HLS) was newly calculated based on smoking status, physical activity, diet, body mass index, and mental health. Cox's proportional hazards models were used to assess the associations between sleep patterns, HLS, and CKD risk. RESULTS A total of 17,357 incident CKD cases were identified during a median follow-up of 14.5 (interquartile range: 13.7-15.3) years. Both sleep patterns and HLS were independently associated with increased CKD risk (p-trend < 0.001). Importantly, the HLS was found to modify the association between sleep patterns and CKD risk (p-interaction = 0.026). Among participants with a low HLS, medium (HR = 1.12; 95% CI 1.05-1.19) and poor sleep patterns (HR = 1.23; 95% CI 1.17-1.30) increased CKD risk to varying degrees, whereas no significant association was observed for a high HLS. Moreover, the combination of a low HLS and poor sleep pattern significantly increased the risk of incident CKD (HR = 2.19; 95% CI 2.00-2.40). CONCLUSIONS A high HLS may significantly reduce CKD risk associated with poor sleep, whereas a low HLS may exacerbate this risk. These findings underscore the critical importance of lifestyle interventions as a primary prevention strategy for CKD.
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Affiliation(s)
- Xia Lin
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250002, China
| | - Jiali Lv
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250002, China
| | - Shuai Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250002, China
| | - Xiaoyan Ma
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250002, China
| | - Xiaofeng Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250002, China
| | - Cheng Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250002, China
| | - Tao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250002, China
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Li Q, Shan Y, Liao J, Wang L, Wei Y, Dai L, Kan S, Shi J, Huang X, Lu G. Association of daytime napping with incidence of chronic kidney disease and end-stage kidney disease: A prospective observational study. PLoS One 2024; 19:e0298375. [PMID: 38512875 PMCID: PMC10956792 DOI: 10.1371/journal.pone.0298375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/24/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND AND AIMS Few studies have examined the relationship between daytime napping and risk of kidney diseases. We aimed to investigate the association of daytime napping with the incidence of chronic kidney disease (CKD) and end-stage kidney disease (ESKD). We also examined whether sleep duration modified the association of nap with CKD or ESKD. METHODS We recruited 460,571 European middle- to older-aged adults without prior CKD or ESKD between March 13, 2006, and October 1, 2010, in the UK Biobank. Sleep behavior data were obtained through questionnaires administered during recruitment. The analysis of the relationship between napping and the occurrence of CKD and ESKD utilized Cox proportional hazards regression models. The modification role of sleep duration on the effect of nap on CKD and ESKD was also examined. RESULTS After a mean follow-up of 11.1 (standard deviation 2.2) years, we observed 28,330 incident CKD cases and 927 ESKD cases. The daytime napping was associated with incident CKD (P for trend = .004). After fully adjusted, when compared with participants who did not take nap, those in sometimes and usually nap groups had higher risk of CKD. Nevertheless, the available evidence did not support a link between daytime napping and ESKD (P for trend = .06). Simultaneously, there was insufficient evidence suggesting that sleeping duration modified the association of daytime napping with incident CKD or ESKD. CONCLUSION Daytime napping was associated with an increased risk of CKD. However, the absence of conclusive evidence did not indicate a connection between daytime napping and ESKD.
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Affiliation(s)
- Qinjun Li
- Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Nephrology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ying Shan
- Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Renal Division, Department of Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Jingchi Liao
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Ling Wang
- Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Nephrology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yanling Wei
- Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Renal Division, Department of Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Liang Dai
- Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Renal Division, Department of Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Sen Kan
- Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Nephrology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jianqing Shi
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, Guangdong, China
- Department of Statistics and Data Science, National Center for Applied Mathematics, Shenzhen, Guangdong, China
| | - Xiaoyan Huang
- Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Renal Division, Department of Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Guoyuan Lu
- Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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