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Abstract: PO1321

Pittsburgh Sleep Quality Index Score Predicts All-Cause Mortality Independently in Chinese Dialysis Patients

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Liu, Bo, Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
  • Han, Qianqian, Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
  • Fu, Sha, Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
  • Liang, Peifen, Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
  • Li, Bin, Clinical Trials Unit, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
  • Yang, Qiongqiong, Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
Background

Poor sleep quality (SQ) is common in dialysis patients. The Pittsburgh Sleep Quality Index (PSQI) is a standard tool for evaluating SQ with high validity and reliability. The relationship of PSQI score to survival in dialysis patients has not been well studied. Less was reported in China. The aim of this study was to explore the association between PSQI score and all-cause mortality in Chinese dialysis patients.

Methods

Dialysis patients who were treated for more than 3 months in Sun Yat-sen Memorial Hospital of Sun Yat-sen University between April 1, 2006 and Aug 1, 2017 and completed questionnaires on SQ were enrolled in this retrospective study. The PSQI was used to evaluate SQ. PSQI score >5 or ≤5 were considered to indicate "poor sleepers" or "good sleepers" respectively. The primary outcomes was all-cause mortality. Restrictive cubic spline (RCS) regression models were used to examine the dose-response relationship between PSQI score and all-cause mortality. Cox proportional hazards regression analysis was performed.

Results

109 patients were included, composed of 51 hemodialysis and 58 peritoneal dialysis patients. Mean follow-up time was 69.1 ± 29.9 months, during which 21 deaths occurred. 67 (61.5%) patients had poor SQ. Compared with poor sleepers, good sleepers had significantly higher levels of hemoglobin [78.0 (68.0, 97.0) vs. 74.0 (61.0, 85.0), P = 0.030] and carbondioxide combining power (20.0 ± 3.7 vs. 18.0 ± 4.5, P = 0.022). RCS analysis showed that 7 was the cutoff value at which the effect of PSQI score on mortality changed. More than 7 of PSQI score increased the risk on all-cause mortality. When PSQI score was analyzed as a continuous variable in the multivariate Cox proportional hazards model, it was associated significantly with all-cause mortality (hazard ratio [HR] = 1.20, 95% confidence interval [95% CI] 1.05, 1.36, P = 0.007). While a threshold of 7 on the PSQI score was used in an additional adjusted model, a PSQI score > 7 was associated with a 2.96 times increase in the hazard for all-cause mortality (HR = 2.96, 95% CI 1.15, 7.61, P = 0.025).

Conclusion

PSQI score > 7 predicted all-cause mortality independently in Chinese dialysis patients. Further studies are needed to confirm decreasing PSQI score less than 7 in Chinese dialysis patients will improve survival.