The association of sleep duration with the risk of chronic kidney disease: a systematic review and meta-analysis.

ABSTRACT

Background and hypothesis: Published literature suggests that sleep duration and quality may be affected in adults with chronic kidney disease. However, the relationship between these two entities remains a matter of debate. The objective of this systematic review and meta-analysis is to assess the effect of sleep duration and quality on chronic kidney disease. Methods: A systematic review of the Medline/PubMed, Embase, Cochrane Library, and CINAHL databases was conducted for articles pertaining to the association between sleep duration and quality on chronic kidney disease. The main outcome was the hazard/risk ratio of chronic kidney disease in patients of varying sleep durations and quality. Results: In total, 42 studies (2 613 971 patients) with a mean age of 43.55 ± 14.01 years were included in the meta-analysis. Compared with a reference range of 7 to 8 hours of sleep, short sleep durations of ≤4 hours (RR 1.41, 95% CI 1.16 to 1.71, P < 0.01), ≤5 hours (RR 1.46, 95% CI 1.22 to 1.76, P < 0.01), ≤6 hours (RR 1.18, 95% CI 1.09 to 1.29, P < 0.01), and ≤7 hours (RR 1.19, 95% CI 1.12 to 1.28, P < 0.01) were significantly associated with an increased risk of incident chronic kidney disease. Long sleep durations of ≥8 hours (RR 1.15, 95% CI 1.03 to 1.28, P < 0.01) and ≥9 hours (RR 1.46, 95% CI 1.28 to 1.68, P < 0.01) were also significantly associated with an increased risk of incident chronic kidney disease. Meta-regression did not find any significant effect of age, gender, geographical region, and BMI and an association with sleep duration and risk of incident chronic kidney disease. Conclusion: Both short and long sleep durations were significantly associated with a higher risk of chronic kidney disease. Interventions targeted toward achieving an optimal duration of sleep may reduce the risk of incident chronic kidney disease.