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Abstract: FR-PO410

Functional Outcomes of Sleep Predict All-Cause Mortality in Incident Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Fitzpatrick, Jessica, The Hospital for Sick Children, Toronto, Ontario, Canada
  • Kerns, Eric S., Lahey Clinic, Burlington, Massachusetts, United States
  • Sozio, Stephen M., Johns Hopkins University, Baltimore, Maryland, United States
  • Estrella, Michelle M., UCSF and San Francisco VA Medical Center, San Francisco, California, United States
  • Jaar, Bernard G., Johns Hopkins University, Baltimore, Maryland, United States
  • Parekh, Rulan S., The Hospital For Sick Children, Toronto, Ontario, Canada
  • Bourjeily, Ghada, Miriam Hospital/Brown University, Providence, Rhode Island, United States
Background

Patients with ESRD commonly experience sleep disturbances. Fatigue, difficulty concentrating, and memory impairment are functional outcomes of poor sleep measurable by validated questionnaire. Although sleep disturbances are associated with increased risk of mortality in patients initiating hemodialysis, it is unclear if functional outcomes of sleep impact mortality risk. We sought to examine whether functional outcomes of poor sleep are associated with an increased risk of mortality in patients initiating hemodialysis.

Methods

In 228 participants enrolled in the Predictors of Arrhythmic and Cardiovascular risk in ESRD (PACE) study, the validated Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10), which assesses functional outcomes of daytime sleepiness through 5 domains (productivity, activity level, social outcomes, vigilance and sexual relationship), was administered within 6 months of enrollment. Proportional hazards regression was used to examine the association of FOSQ-10 score with all-cause mortality. Effect modification was tested using multiplicative interaction terms.

Results

Mean age was 55 years, median body mass index was 28 (IQR 24,33), with 68% African American. During 816 person-years of follow-up, there were 95 deaths. Each 0.1 log decrease in FOSQ-10 score was associated with increased risk of mortality (HR 1.09, 95%CI 1.01-1.18), independent of clinical covariates. [Figure] This association was not modified by age, sex, race, or history of diabetes.

Conclusion

In adults initiating dialysis, poor functional outcomes of sleep are associated with increased risk of overall mortality. Future studies should assess the impact of screening for sleep disturbances in ESRD patients to identify individuals at increased risk of death.

Funding

  • NIDDK Support