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Abstract: TH-PO290

Association Between Sleep Quality and Cardiovascular Disease in Maintenance Hemodialysis Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Tian, Han, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
  • Wang, Lulu, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
  • Yang, Junwei, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
  • Ye, Hong, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
  • Jiang, Lei, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
Background

Most patients on maintenance hemodialysis (MHD) have sleep disorders. Studies have shown that poor sleep quality is associated with a variety of diseases, such as diabetes, cardiovascular disease (CVD), and depression. However, few studies have investigated sleep quality in the population of Chinese patients on hemodialysis. This study aimed to analyze sleep quality in patients on maintenance hemodialysis (MHD), and assess the impact of sleep quality on their prognosis.

Methods

A total of 601 patients on MHD were prospectively included in this cohort study. Pittsburgh sleep quality index (PSQI) was used to evaluate the sleep quality of patients. The global PSQI score > 7 indicates that a person with poor sleep quality. Follow-up was conducted until December 31 2022, with all-cause death and major adverse cardiovascular events (MACEs) as the endpoint events. Correlations between sleep quality and incidences of endpoint events were analyzed using Cox risk regression models.

Results

Of the 601 patients, 595 completed the PSQI assessment, with 278 (46.7%) having poor sleep quality. Patients in the PSQI>7 group were older (p<0.001) and had a higher proportion of comorbid cardiovascular disease (CVD, p<0.001) and diabetes (p=0.002). Years of education (p=0.028), diastolic blood pressure (p=0.002), and heart rate (p=0.005) were lower in the PSQI>7 group than in the PSQI≤7 group. The 595 patients were followed up for 3 (2.5-3.7) years, during which 116 (19.4%) died, 415 (69.8%) survived, 64 (10.8%) were lost to follow-up, and 115 (19.3%) experienced MACEs. After adjusting for confounding factors such as age, gender, dialysis age, and previous cardiovascular disease, the risk of MACE in patients with poor sleep quality was twice that of patients with good sleep quality (HR=2.037 (1.339, 3.097), p=0.001). There was no significant difference in the risk of all-cause death between the two groups (HR=0.851 (0.584,1.240), p=0.4).

Conclusion

The prevalence of poor sleep quality in patients on MHD was 46.7%. Poor sleep quality was independent risk factor for MACEs in patients on MHD.

Funding

  • Government Support – Non-U.S.