The impact of sleep duration on the incidence of new-onset chronic kidney disease in community-dwelling adults: a nationwide cohort study

Abstract

Background : This research examined the association between sleep duration and new-onset chronic kidney disease (CKD) among community-dwelling middle-aged and elderly individuals in Korea. Methods : This prospective cohort study utilized data from the Korean Genome and Epidemiology Study (KoGES) from 2001-2002 (baseline) to 2019-2020 (tenth follow-up visit). New-onset CKD was the primary outcome, defined as an estimated glomerular filtration rate <60 mL/min/1.73 m(2) or the proteinuria. Study populations were classified into six self-reported sleep length categories: <5h, 5h <= to <6h, 6h <= to <7h, 7h <= to <= 8h, 8h < to <9h, and 9h/day <=. Cox proportional hazards models were used to ascertain the hazard ratios (HRs) and 95% confidence intervals (CIs) for CKD incidence across these categories. Results : Over a median follow-up duration of 17.41 years, CKD was identified in 551 (14.4%) of 3835 participants (mean age 48.7 +/- 7.5 years). After adjusting for confounding variables, a U-shaped relationship between sleep lengths and CKD was identified. Participants with insufficient (<5h) and excessive (9h <=) sleep length exhibited HRs for CKD incidence of 1.44 (1.09-1.89) and 1.85 (1.04-3.27), respectively, compared to individuals with normal sleep length (7h <= to <= 8h). Age and sex differences were observed in the association between sleep length and CKD incidence. The association between sleep duration and new-onset CKD was significant only in participants aged 40 to 64 years, with no significant association observed in individuals aged 65 years and older. Conclusions : This research identified a relationship between the amount of sleep and CKD in Korean adults. Maintaining an appropriate sleep duration of 7-8 h/day is important for preventing new-onset CKD.