Sleeping, Smoking, and Kidney Diseases: Evidence From the NHANES 2017-2018

Chia-Chao Wu; Han-En Wang; Yi-Chun Liu; Cai-Mei Zheng; Pauling Chu; Kuo-Cheng Lu; Chi-Ming Chu; Yu-Tien Chang

doi:10.3389/fmed.2021.745006

Sleeping, Smoking, and Kidney Diseases: Evidence From the NHANES 2017-2018

Front Med (Lausanne). 2021 Sep 28:8:745006. doi: 10.3389/fmed.2021.745006. eCollection 2021.

Authors

Chia-Chao Wu^{1

2}, Han-En Wang¹, Yi-Chun Liu³, Cai-Mei Zheng^{4

5

6}, Pauling Chu¹, Kuo-Cheng Lu⁷, Chi-Ming Chu^{3

8

9

10

11}, Yu-Tien Chang³

Affiliations

¹ Division of Nephrology, Department of Internal Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.
² National Defense Medical Center, Department and Graduate Institute of Microbiology and Immunology, Taipei, Taiwan.
³ School of Public Health, National Defense Medical Center, Taipei City, Taiwan.
⁴ Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
⁵ TMU Research Centre of Urology and Kidney, Taipei Medical University, Taipei, Taiwan.
⁶ Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁷ Division of Nephrology, Department of Medicine, School of Medicine, Fu-Jen Catholic Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan.
⁸ Department of Surgery, National Defense Medical Center, Songshan Branch of Tri-Service General Hospital, Taipei City, Taiwan.
⁹ Division of Biostatistics and Informatics, Department of Epidemiology, National Defense Medical Center, School of Public Health, Taipei, Taiwan.
¹⁰ Department of Public Health, China Medical University, Taichung City, Taiwan.
¹¹ Department of Public Health, Kaohsiung Medical University, Kaohsiung City, Taiwan.

Abstract

Study Objectives: Smoking and sleep are modifiable factors associated with the chronic kidney diseases. However, the interaction of smoking and sleep on the renal function are still unclear. Therefore, we aimed to evaluate the interactive impacts of smoking and sleep on the renal function. Methods: Data were obtained from the National Health and Nutrition Examination Survey. The study population were categorized into nine subgroups by smoking (smoking every day, sometimes, and non-smokers recently) and sleep duration (short duration ≤ 6 h, normal duration 6-9 h, and longer duration ≥ 9 h on the weekdays). Results: The study group with a short sleep duration had significantly higher serum cotinine and hydrocotinine levels compared with the other two sleep groups. After adjusting the demographic characteristics (age, race, body mass index, and marital status), sleep quality (snoring or breathing cessation), and comorbidities (diabetes mellitus, hypertension, high cholesterol, anemia, congestive heart failure, coronary heart disease, and stroke), non-smokers with short or long sleep duration had significant lower estimated glomerular filtration rate (eGFR) levels than the study group who smoked every day and slept ≤ 6 h. The effects of sleep duration on eGFR levels varied with smoking status. For the study group smoking every day, eGFR levels increased as sleep duration decreased, whereas for the study group smoking sometimes, eGFR levels increased as sleep duration increased. The U-shaped effects of eGFR levels were observed among non-smokers whose normal sleep duration was associated with better eGFR levels. Normal sleep duration was an important protective factor of the renal function for non-smokers than smokers. Conclusions: The effects of sleep duration on eGFR levels varied with smoking status. Normal sleep duration was a protective factor and more crucial for non-smokers than for smokers.

Keywords: NHANES; eGFR; kidney function; sleep; smoking.