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Abstract
Introduction: Patients with advanced chronic kidney disease suffer from a wide variety of physical and psychological symptoms. In final stages, they suffer significant alterations in physical, mental, emotional and social health, highlighting the impact on the quality of sleep.
Objective: To analyse the main sleep disorders in patients with Advanced Chronic Kidney Disease (ACKD).
paMaterial
and Methods: A cross-sectional descriptive observational study was carried out in the Nephrology Unit of the Reina Sofía University Hospital (Córdoba) in patients with ACKD in stages 4-5. Sleep disturbances were studied using the Pittsburg Sleep Quality Index questionnaire as well as the relationship with other variables such as age, sex, comorbidity, Haemoglobin, Serum Creatinine, and Body Mass Index.
Results: 119 patients were studied, with a mean age of 67.61±14.89 years; 52 women (43.7%). The mean value of the Sleep Quality Index was 9.66±4 points. 83.2% of the patients had sleep disturbances (score> 5 points). A significant relationship was found with comorbidity and age. No relationships were found between sleep disturbances with sex, renal clearance or Body Mass Index.
Conclusion: A large percentage of patients with ACKD in stages 4-5 have sleep disturbances. These alterations are related to greater comorbidity and advanced age; sex, renal clearance or Body Mass Index have not shown a relationship, at least in the sample studied.
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Copyright (c) 2020 Ana Moreno-Egea, Mónica Romero-Reyes, Mª Victoria Gómez-López, Rodolfo Crespo-Montero
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References
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- Otero A, de Francisco A, Gayoso P, García F. Prevalencia de la insuficiencia renal crónica en España: Resultados del estudio EPIRCE. Nefrología. 2010; 30:78-86.
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- Rebollo-Rubio A, Morales-Asencio JM, Pons-Raventós ME, Mansilla-Francisco JJ. Revisión de estudios sobre calidad de vida relacionada con la salud en la enfermedad renal crónica avanzada en España. Nefrología. 2015;35(1):92-109.
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- Sanz-Guajardo D, Orte L, Gómez-Campderá F, Fernández E, Aguilar MD, Lázaro P. Calidad de vida en los pacientes con insuficiencia renal crónica. Influencia de la intervención precoz del nefrólogo y de la consulta prediálisis. Nefrología. 2006;26(3):56-65.
- Gutiérrez D, Leiva J, Macías M, Cuesta A. Perfil sintomático de los pacientes con Enfermedad Renal Crónica Estadio 4 y 5. Enferm Nefrol. 2017; 20(3):256-66.
- Serrano-Navarro I, Mesa-Abad P, Tevar-Muñoz L, Crespo-Montero R. Trastornos del sueño en el paciente con enfermedad renal crónica avanzada. Enferm Nefrol. 2019; 22(4):361-78.
- Tenorio Cárcamo G, Barrios Araya S. Alteraciones del sueño más frecuentes en personas en diálisis. Enferm Nefrol. 2018; 21(4):317-33.
- Restrepo D, Cardeño C. Trastornos de sueño en los pacientes en diálisis. Rev Colomb Psiquiatr. 2010; 39(3):588–600. DOI: https://doi.org/10.1016/S0034-7450(14)60227-4
- Restrepo D, Hidalgo P, Gómez C, Gil F, Cardeño C. Trastornos del sueño en pacientes en hemodiálisis. Rev Colomb Psiquiat 2011;40(3):433-45. DOI: https://doi.org/10.1016/S0034-7450(14)60138-4
- Shafi S, Shafi T. A comparison of quality of sleep between patients with chronic kidney disease not on hemodialysis and end- stage renal disease on hemodialysis in a developing country. Ren Fail 2017; 39(1):623-28. DOI: https://doi.org/10.1080/0886022X.2017.1361836
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- Su-Ah Sung, Young Youl Hyun, Kyu Beck Lee, Hayne Cho Park, Wookyung Chung, Yeong Hoon Kim, et al. Sleep Duration and Health-Related Quality of Life in Predialysis CKD. Clin J Am Soc Nephrol. 2018; 13(6):858-65. DOI: https://doi.org/10.2215/CJN.11351017
- Roumelioti M, Argyropoulos C, Buysse D, Nayar H, Steven W, Unruh M. Sleep Quality, Mood, Alertness and Their Variability in CKD and ESRD. Nephron Clin Pract. 2010;114(4):277-87. DOI: https://doi.org/10.1159/000276580
- Catunda J, Barroso R, Alburquerque L, Oswaldo A, Gutiérrez A, Carvalhedo F, Meireles V. Sleep disturbances in patients on maintenance hemodialysis: role of dialysis shift. Rev Assoc Med Bras. 2007; 53(6):492-96. DOI: https://doi.org/10.1590/S0104-42302007000600014
- Chao-Ying T, Yu-Hsiang C, Yu-Hsuan L, Huang W. Sleep and emotional disturbance in patients with non-dialysis chronic kidney disease. J Formos Med Assoc. 2019;118(6):986-94. DOI: https://doi.org/10.1016/j.jfma.2018.10.016
- Schweitzer ML, Stengel B, Legrand K, Briançon S, Jacquelinet C, Combe, C,et al. Obesity phenotype and patient- reported outcomes in moderate and severe chronic kidney disease: a cross-sectional study from the CKD-REIN cohort study. Qual Life Res. 2019;28(7):1873-83. DOI: https://doi.org/10.1007/s11136-019-02110-2
- Pons Raventos E, Rebollo Rubio A, Amador Coloma R. Utilidad del índice de masa corporal con enfermedad renal crónica. Rev Seden. 2017. 20(4):316-22.
References
Vanholder R, Annemans L, Brown E, Gansevoort R, Gout-Zwart JJ, Lameire N, et al. European Kidney Health Alliance. Reducing the costs of chronic kidney disease while delivering quality health care: A call to action. Nat Rev Nephrol. 2017;13:393-409. DOI: https://doi.org/10.1038/nrneph.2017.63
Wang V, Vilme H, Maciejewski ML, Boulware LE. The economic burden of chronic kidney disease and end-stage renal disease. Semin Nephrol. 2016; 36:319-30. DOI: https://doi.org/10.1016/j.semnephrol.2016.05.008
R. Alcázar-Arroyo, L. Enfermedad Renal Crónica Avanzada. Rev Nefrol. 2008;28(S3):3-6.
Otero A, de Francisco A, Gayoso P, García F. Prevalencia de la insuficiencia renal crónica en España: Resultados del estudio EPIRCE. Nefrología. 2010; 30:78-86.
Guerrero MA, Toro FJ, Batalha P, Salgueira M, González F, Marrero S, et al. Estudio ERCA. Características basales, evaluación de la aplicación de la información estructurada para la elección de tratamiento renal sustitutivo y evolución a un año de los pacientes incidentes en la consulta ERCA. Nefrología. 2019;39(6):563-82.
Rebollo-Rubio A, Morales-Asencio JM, Pons-Raventós ME, Mansilla-Francisco JJ. Revisión de estudios sobre calidad de vida relacionada con la salud en la enfermedad renal crónica avanzada en España. Nefrología. 2015;35(1):92-109.
Garrido-Blanco R, Arroyo-Priego E, Arana-Ruiz AI, López-Zamorano MD, Tierno-Tendero C, Crespo-Montero R. Calidad de vida y enfermedad renal crónica avanzada. Influencia del aclaramiento renal. Enferm Nefrol 2018;21(4):359-67.
Sanz-Guajardo D, Orte L, Gómez-Campderá F, Fernández E, Aguilar MD, Lázaro P. Calidad de vida en los pacientes con insuficiencia renal crónica. Influencia de la intervención precoz del nefrólogo y de la consulta prediálisis. Nefrología. 2006;26(3):56-65.
Gutiérrez D, Leiva J, Macías M, Cuesta A. Perfil sintomático de los pacientes con Enfermedad Renal Crónica Estadio 4 y 5. Enferm Nefrol. 2017; 20(3):256-66.
Serrano-Navarro I, Mesa-Abad P, Tevar-Muñoz L, Crespo-Montero R. Trastornos del sueño en el paciente con enfermedad renal crónica avanzada. Enferm Nefrol. 2019; 22(4):361-78.
Tenorio Cárcamo G, Barrios Araya S. Alteraciones del sueño más frecuentes en personas en diálisis. Enferm Nefrol. 2018; 21(4):317-33.
Restrepo D, Cardeño C. Trastornos de sueño en los pacientes en diálisis. Rev Colomb Psiquiatr. 2010; 39(3):588–600. DOI: https://doi.org/10.1016/S0034-7450(14)60227-4
Restrepo D, Hidalgo P, Gómez C, Gil F, Cardeño C. Trastornos del sueño en pacientes en hemodiálisis. Rev Colomb Psiquiat 2011;40(3):433-45. DOI: https://doi.org/10.1016/S0034-7450(14)60138-4
Shafi S, Shafi T. A comparison of quality of sleep between patients with chronic kidney disease not on hemodialysis and end- stage renal disease on hemodialysis in a developing country. Ren Fail 2017; 39(1):623-28. DOI: https://doi.org/10.1080/0886022X.2017.1361836
Zhang J, Wang C, Gong W, Peng H, Tang Y, Cui C et al. Association between sleep quality and cardiovascular damage in predialysis patients with chronic kidney disease. BMC Nephrology. 2014;15,131:1-9.
Sekercioglu N, Curtis B, Murphy S, Barret B. Sleep quality and its correlates in patients with chronic kidney disease: a cross- sectional design. Ren fail. 2015;37(5):757-62. DOI: https://doi.org/10.3109/0886022X.2015.1024555
Luna Y, Robles Y, Agüero Y. Validación del Índice de calidad de sueño de Pittsburg en una muestra peruana. Anal Salud Ment 2015;31(2):23-30.
Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245-51. DOI: https://doi.org/10.1016/0895-4356(94)90129-5
Guney I., Akgul Y, Gencer V, Aydemir H, Asian U, Ecirli S. Sleep Quality and Risk Factors of Atherosclerosis in Predialysis Chronic Kidney Disease. Int J Artif Organs. 2016;39(11):563-69. DOI: https://doi.org/10.5301/ijao.5000536
Su-Ah Sung, Young Youl Hyun, Kyu Beck Lee, Hayne Cho Park, Wookyung Chung, Yeong Hoon Kim, et al. Sleep Duration and Health-Related Quality of Life in Predialysis CKD. Clin J Am Soc Nephrol. 2018; 13(6):858-65. DOI: https://doi.org/10.2215/CJN.11351017
Roumelioti M, Argyropoulos C, Buysse D, Nayar H, Steven W, Unruh M. Sleep Quality, Mood, Alertness and Their Variability in CKD and ESRD. Nephron Clin Pract. 2010;114(4):277-87. DOI: https://doi.org/10.1159/000276580
Catunda J, Barroso R, Alburquerque L, Oswaldo A, Gutiérrez A, Carvalhedo F, Meireles V. Sleep disturbances in patients on maintenance hemodialysis: role of dialysis shift. Rev Assoc Med Bras. 2007; 53(6):492-96. DOI: https://doi.org/10.1590/S0104-42302007000600014
Chao-Ying T, Yu-Hsiang C, Yu-Hsuan L, Huang W. Sleep and emotional disturbance in patients with non-dialysis chronic kidney disease. J Formos Med Assoc. 2019;118(6):986-94. DOI: https://doi.org/10.1016/j.jfma.2018.10.016
Schweitzer ML, Stengel B, Legrand K, Briançon S, Jacquelinet C, Combe, C,et al. Obesity phenotype and patient- reported outcomes in moderate and severe chronic kidney disease: a cross-sectional study from the CKD-REIN cohort study. Qual Life Res. 2019;28(7):1873-83. DOI: https://doi.org/10.1007/s11136-019-02110-2
Pons Raventos E, Rebollo Rubio A, Amador Coloma R. Utilidad del índice de masa corporal con enfermedad renal crónica. Rev Seden. 2017. 20(4):316-22.