Factores asociados a mala calidad de sueño en pacientes con insuficiencia renal crónica en hemodiálisis

Bruce Peña-Martínez, Veronica Navarro, Harumi Oshiro, Antonio Bernabe-Ortiz
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引用次数: 2

Abstract

Introduction and objectives

Sleep disorders are one of the most common comorbidities among patients on hemodialysis. The aims of this study were to determine the prevalence of poor sleep quality as well as to establish potential factors associated with poor sleep quality.

Materials and methods

A cross-sectional study was performed enrolling patients with chronic kidney disease on hemodialysis. The outcome was sleep quality evaluated using the Pittsburgh Scale, whereas the exposure variables were time on hemodialysis, history of type-2 diabetes and hypertension, depressive symptoms, anemia, and uremia. We used Poisson regression model to determine the association of interest, reporting prevalence ratios (PR) and 95% confidence intervals (95%CI).

Results

A total of 450 patients were enrolled, 259 (57.5%) were male, aged from 18 to 97 years. The prevalence of poor sleep quality was 79.3% (95%CI: 75.6%–83.1%). Poor sleep quality was associated with depressive symptoms (PR = 1.28; 95%CI: 1.17-1.39), anemia (PR = 1.18; 95%CI: 1.04-1.34) and uremia (PR = 1.26; 95%CI: 1.17-1.36) after controlling for potential confounders.

Conclusions

The presence of depressive symptoms, anemia and uremia were positively associated with poor sleep quality among patients with chronic kidney disease on hemodialysis. A great proportion of this population had poor sleep quality. Strategies are needed to improve sleep quality in these patients.

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血液透析慢性肾衰竭患者睡眠质量差的相关因素
前言与目的睡眠障碍是血液透析患者最常见的合并症之一。本研究的目的是确定睡眠质量差的普遍程度,并确定与睡眠质量差相关的潜在因素。材料与方法采用横断面研究方法,纳入血液透析的慢性肾脏疾病患者。结果是使用匹兹堡量表评估睡眠质量,而暴露变量是血液透析时间、2型糖尿病和高血压史、抑郁症状、贫血和尿毒症。我们使用泊松回归模型来确定兴趣、报告患病率(PR)和95%置信区间(95% ci)之间的关系。结果共纳入450例患者,其中男性259例(57.5%),年龄18 ~ 97岁。睡眠质量差的患病率为79.3% (95%CI: 75.6% ~ 83.1%)。睡眠质量差与抑郁症状相关(PR = 1.28;95%CI: 1.17-1.39),贫血(PR = 1.18;95%CI: 1.04-1.34)和尿毒症(PR = 1.26;95%CI: 1.17-1.36),控制了潜在的混杂因素。结论慢性肾病血液透析患者出现抑郁症状、贫血和尿毒症与睡眠质量差呈正相关。其中很大一部分人的睡眠质量很差。需要一些策略来改善这些患者的睡眠质量。
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