Sleep Disturbance as a Nontraditional Risk Factor in CKD

睡眠障碍是 CKD 的非传统危险因素

• 批准号: 7987601
• 负责人: Eve Van Cauter
• 金额: $ 10.46万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-11-25 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7987601
• 关键词: Adult; Adverse effects; Age; Ancillary Study; Ankle; Blood Pressure; Body Fluids; C-reactive protein; Cardiovascular Diseases; Cardiovascular Physiology; Cardiovascular system; Cessation of life; Characteristics; Chicago; Chronic; Chronic Disease; Chronic Kidney Failure; Chronic Kidney Insufficiency; Clinical Research; Cohort Studies; Deterioration; Development; Diabetes Mellitus; End stage renal failure; Enrollment; Epidemic; Epidemiology; Equilibrium; Ethnic Origin; Event; Excessive Daytime Sleepiness; Fluid Balance; Functional disorder; Gender; General Population; Glomerular Filtration Rate; Heart Rate; Home environment; Hormonal; Hormones; Hyperactive behavior; Hypertension; Illinois; Inflammatory; Insulin Resistance; Kidney; Laboratories; Laboratory Study; Left Ventricular Mass; Leg; Link; Measures; Monitor; Movement; Movement Disorders; National Institute of Diabetes and Digestive and Kidney Diseases; Obesity; Overweight; Pathology; Patients; Pattern; Plasma; Polysomnography; Prevalence; Public Health; Questionnaires; Recruitment Activity; Renal function; Renin-Angiotensin-Aldosterone System; Research Personnel; Restless Legs Syndrome; Risk; Risk Factors; Role; Sample Size; Severities; Sleep; Sleep Apnea Syndromes; Sleep disturbances; Sleeplessness; Societies; Study Subject; Testing; Universities; Wakefulness; Wrist; cardiovascular risk factor; cohort; cytokine; diabetic patient; glucose tolerance; high risk; improved; indexing; mortality; non-diabetic; programs

There is increasing evidence from both epidemiologic and laboratory studies for an association between sleep duration and/or quality and the prevalence and/or severity of major chronic diseases, including diabetes and cardiovascular disease. Sleep disturbances, particularly sleep disordered breathing (SDB) and periodic leg movements (PLM), are more prevalent in patients with chronic kidney disease (CKD) than in the general population. Because the hormones involved in the control of kidney function are markedly modulated by sleep, it is possible that sleep disturbances have an adverse effect on kidney function. The present proposal therefore seeks to explore the role of decreased sleep duration and/or quality as a risk factor for the progression of chronic renal insufficiency and the development of cardiovascular disease in CKD. This study has two over-arching hypotheses: 1. Sleep quality will be a predictor of the progression of CKD, and 2. Sleep quality will be a predictor of cardiovascular disease in CKD. This project will be an ancillary study to an ongoing longitudinal cohort study, the Chronic Renal Insufficiency Study (CRIC). Specific Aim 1 will involve assessment of habitual at-home sleep duration and quality (by wrist and leg activity monitoring, logs and questionnaires) to predict changes in renal and cardiovascular measures over study period in CRIC subjects. Specific Aim 2 will examine changes in polysomnographic variables, including measures of SDB and PLM, to predict changes in renal and cardiovascular measures over study period in CRIC subjects. Specific Aim 3 will delineate the relationship between hormones controlling body fluid balance, cardiovascular function and sleep in mild to moderate CKD patients as compared to normal controls to identify possible pathophysiological mechanisms. Overall, the proposed studies will determine if poor sleep quality accelerates the development or increases the severity of CKD and of cardiovascular disease in CKD and if strategies to improve sleep quality may have beneficial effects on CKD.

流行病学和实验室研究越来越多的证据表明， 睡眠持续时间和/或质量以及主要慢性疾病的患病率和/或严重程度，包括 糖尿病和心血管疾病。睡眠障碍，特别是睡眠呼吸障碍 (SDB) 和周期性腿部运动 (PLM) 在慢性肾脏病 (CKD) 患者中比 在一般人群中。因为参与控制肾功能的激素明显 睡眠受到睡眠调节，睡眠障碍可能会对肾功能产生不利影响。这 因此，本提案旨在探讨睡眠持续时间和/或质量减少作为风险的作用 慢性肾功能不全进展和心血管疾病发展的因素 慢性肾病。这项研究有两个总体假设： 1. 睡眠质量将是进展的预测因素 2. 睡眠质量将是 CKD 心血管疾病的预测因子。该项目将是一个 正在进行的纵向队列研究慢性肾功能不全研究（CRIC）的辅助研究。 具体目标 1 将涉及评估习惯性在家睡眠持续时间和质量（通过手腕和腿部 活动监测、日志和问卷）来预测肾脏和心血管指标的变化 CRIC科目的学习期。具体目标 2 将检查多导睡眠图变量的变化， 包括 SDB 和 PLM 的测量，以预测研究期间肾脏和心血管测量的变化 CRIC 主题期间。具体目标3将描述控制身体的激素之间的关系 与正常人相比，轻至中度 CKD 患者的液体平衡、心血管功能和睡眠 控制以确定可能的病理生理机制。总体而言，拟议的研究将确定是否 睡眠质量差会加速 CKD 和心血管疾病的发展或加重其严重程度 慢性肾病 (CKD) 疾病以及改善睡眠质量的策略是否可能对慢性肾病 (CKD) 产生有益影响。