Adherence to a healthy sleep pattern and new-onset acute kidney injury

Abstract

Objectives: To investigate the prospective association of individual sleep characteristics and a healthy sleep pattern with new-onset acute kidney injury in general population.

Methods: The UK Biobank enrolled over 500,000 participants, aged 37-73years, across the UK from 2006 to 2010. Of these, 375,216 participants were included in the current study. A healthy sleep score, ranging from 0 to 5 points, was created by combining five major sleep characteristics, including sleep duration, chronotype, insomnia, snoring, and daytime sleepiness. New-onset acute kidney injury was defined by ICD-10 code N17, ascertained by primary care data, hospital inpatient data, death register records, or self-reported medical conditions.

Results: During a median follow-up period of 12.0years, 14,492 (3.9%) participants developed acute kidney injury. Overall, the healthy sleep score was significantly inversely associated with the risk of new-onset acute kidney injury (per 1-point increment; hazards ratio, 0.95; 95%CI, 0.93-0.97), especially in nondiabetes (hazards ratio, 0.94; 95%CI, 0.92-0.96; vs. diabetes, hazards ratio, 1.01; 95%CI, 0.96-1.05; P-interaction=.008). The genetic predisposition of estimated glomerular filtration rate and acute kidney injury did not significantly modify the association between the healthy sleep score and acute kidney injury (both P-interactions >.05). Sleep 7-8 hours per day (vs. <7 hours or ≥9 hours; hazards ratio, 0.92; 95%CI, 0.88-0.96), early chronotype (vs. evening chronotype; hazards ratio, 0.93; 95%CI, 0.89-0.97), never or rarely insomnia (vs. sometimes/usually insomnia; hazards ratio, 0.93; 95%CI, 0.88-0.97) and no frequent daytime sleepiness (vs. often/always daytime sleepiness; hazards ratio, 0.90; 95%CI, 0.81-0.99) were significantly associated with a lower risk of new-onset acute kidney injury.

Conclusions: A healthy sleep pattern was significantly associated with a lower risk of new-onset acute kidney injury, regardless of the genetic risks.

Keywords: Acute kidney injury; Diabetes mellitus; Genetic risk scores; Sleep characteristics; Sleep pattern; UK Biobank.