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Abstract: FR-PO570

Association of Chronic Insomnia with Protein Energy Wasting in CKD

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical


  • Lu, Jun Ling, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Freire, Amado X., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
  • Kovesdy, Csaba P., Memphis VA Medical Center, Memphis, Tennessee, United States

Chronic insomnia is highly prevalent. Its effects on the sympatho-adrenal system could potentially cause multi-systems abnormalities. It is unknown if chronic insomnia plays a role in the development of protein energy wasting (PEW) in patients with chronic kidney disease (CKD).


In a national cohort of 229,236 CKD patients, we examined associations between chronic insomnia (defined as the presence of ICD9 codes 307.42, 307.49 and 780.52 and long-term use of insomnia medications) and PEW defined as the concomitant presence of serum albumin <3.8 g/dl or serum cholesterol <100 mg/dl, weight loss of 5% or more over 3 months, and neutrophil-to-lymphocyte ratio (NLR) >4.0. Associations were examined in crude logistic regression models (Model 1) and after adjustments for age, gender, race (Model 2), BMI, blood pressure, eGFR, chronic pain (Model 3), and comorbidities and socio-economic status (Model 4).


13,215 patients (5.8% of the cohort) had chronic insomnia and 1,412 (0.6% of the cohort) had PEW. 152 chronic insomnia patients (1.2%) vs. 1,260 patients in control group (0.6%) had PEW. Insomnia was associated with higher odds of PEW events in both unadjusted (Model 1) and in multivariable adjusted models (odds ratio in Model 4: 1.5 [95%CI: 1.3, 1.9], p<0.001), Figure 1. Results were consistent in subgroup analyses.


Chronic insomnia is associated with higher risk of PEW in CKD patients. Further studies are needed to determine underlying mechanisms of action and the effects of interventions.


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