J Nephrol. 2026 Mar 10:aajaf034. doi: 10.1093/joneph/aajaf034. Online ahead of print.
ABSTRACT
Background Advanced chronic kidney disease (CKD) is associated with sleep disturbances, which in turn are linked to cardiovascular morbidity in the general population. However, few studies have examined these associations in individuals with mild to moderate CKD. We aimed to evaluate the association between mild to moderate CKD and sleep disturbances, and the association between sleep disorders and cardiovascular health in this population.Methods We conducted a retrospective study from a cohort of community-dwelling individuals aged 40 to 69 years old. Participants with an estimated glomerular filtration rate (eGFR) lower than 30 mL/min/1.73 m2 were excluded. The association between CKD and the risk of developing sleep disorders during follow-up, as identified through administrative health databases, was evaluated using Cox proportional hazards models adjusted for age, sex, lifestyle factors, and chronic comorbidities. The associations between sleep disorders or self-reported frequent sleeping difficulties at baseline and the risk of cardiovascular events were also examined using adjusted Cox models. All analyses were stratified according to eGFR categories.Results We included 19 973 individuals (mean age 54.2 ± 7.8 years, female 51.6%, 47.0% CKD stage G2, 3.9% CKD stage G3). There were 1299 diagnoses of sleep disorders after a median follow-up of 11.6 years. Stage G3 was associated with an increased risk of sleep disorders (Hazard Ratio [HR] = 1.30, 95% Confidernce Interval [CI]:1.01-1.65). We observed 2213 cardiovascular events during follow-up. Sleep disorders were associated with a higher risk of cardiovascular events in individuals with stage G2 (HR = 2.04, 95% CI:1.49-2.79), while having frequent sleeping difficulties "more than half of the days" was associated with cardiovascular event risk in individuals without CKD (HR = 1.42, 95% CI:1.16-1.72).Conclusions individuals with moderate CKD had a higher risk of sleep disorders. The cardiovascular risk associated with sleep disturbances was influenced by eGFR category.
PMID:41805823 | DOI:10.1093/joneph/aajaf034