Table 5.
Direct and mediated (via allostatic load) effects of sleep pattern on CKD outcomes; stratified by baseline diabetes status
| Sleep measures stratified by diabetes status | Prevalent CKD |
Incident CKD |
eGFR decline |
|||
|---|---|---|---|---|---|---|
| Direct effect OR (95% CI) | Mediated effect OR (95% CI) | Direct effect OR (95% CI) | Mediated effect OR (95% CI) | Direct effect β (95% CI) | Mediated effect β (95% CI) | |
| Diabetes | ||||||
| No. of events/N | 166/485 | 166/485 | 69/242 | 69/242 | 329 | 329 |
| Sleep duration | ||||||
| Very short | 1.66 (0.99 to 2.77) | 0.91 (0.80 to 1.02) | 1.56 (0.71 to 3.40) | 0.91 (0.70 to 1.11) | 0.01 (−0.65 to 0.66) | −0.07 (−0.22 to 0.03) |
| Short | 1.00 (0.60 to 1.69) | 0.91 (0.79 to 1.00) | 1.27 (0.59 to 2.71) | 0.90 (0.70 to 1.09) | −0.68 (−1.30 to −0.07) | −0.08 (−0.22 to 0.01) |
| 7–8 hours | Ref | Ref | Ref | Ref | Ref | Ref |
| Long | 0.66 (0.31 to 1.42) | 1.03 (0.88 to 1.22) | 0.92 (0.28 to 3.00) | 1.05 (0.80 to 1.43) | −0.34 (−1.31 to 0.63) | 0.04 (−0.10 to 0.23) |
| No diabetes | ||||||
| No. of events/N | 227/1881 | 227/1881 | 123/1266 | 123/1266 | 1443 | 1443 |
| Sleep duration | ||||||
| Very short | 1.23 (0.84 to 1.78) | 1.00 (0.95 to 1.05) | 1.20 (0.75 to 1.93) | 0.99 (0.97 to 1.01) | −0.03 (−0.25 to 0.19) | 0.00 (−0.01 to 0.02) |
| Short | 1.09 (0.76 to 1.56) | 1.00 (0.95 to 1.04) | 0.71 (0.43 to 1.16) | 1.00 (0.98 to 1.02) | −0.09 (−0.30 to 0.12) | 0.00 (−0.01 to 0.01) |
| 7–8 hours | Ref | Ref | Ref | Ref | Ref | Ref |
| Long | 1.38 (0.75 to 2.54) | 0.99 (0.90 to 1.09) | 0.35 (0.10 to 1.21) | 1.00 (0.96 to 1.05) | −0.27 (−0.68 to 0.14) | 0.00 (−0.03 to 0.02) |
CI, confidence interval, CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; OR, odds ratio.
All models adjusted for age, sex, educational attainment, household income, employment status, alcohol consumption, and body mass index; the eGFR decline model additionally adjusted for baseline albumin-to-creatinine ratio and eGFR.