Hemodiyaliz hastalarında uyku kalitesi ile inflamatuvar ve biyokimyasal parametreler arasındaki ilişki

Abstract

Amaç: Bu çalışmada, hemodiyaliz hastalarında uyku kalitesi ile inflamatuvar ve biyokimyasal parametreler arasındaki ilişki değerlendirildi. Yöntem: Ocak 2025’te tek merkezli olarak yürütülen kesitsel çalışmaya, en az altı aydır hemodiyaliz tedavisi gören, 18 yaş ve üzeri toplam 195 hasta dahil edildi. Uyku kalitesi Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ile ölçüldü; PUKİ ≤5 “iyi uyku”, PUKİ >5 “kötü uyku” olarak gruplandırıldı. Demografik, klinik ve laboratuvar verileri retrospektif olarak toplandı. Tek değişkenli analiz karşılaştırmaların ardından kötü uyku kalitesinin bağımsız belirleyicilerini saptamak için lojistik regresyon analizi gerçekleştirildi. Bulgular: Hastaların %55’inde kötü uyku kalitesi saptandı. Univaryant analizde kötü uyuyanlarda CRP, lökosit, CRP/Albümin oranı yüksek; hemoglobin, albümin ve HALP skoru düşük bulundu (p<0,05). Çoklu lojistik regresyon modeli, artmış CRP (OR 1,032; %95 GA 1,001–1,064; p=0,043) ve düşük hemoglobin düzeyinin (OR 0,481; %95 GA 0,350–0,660; p<0,001) kötü uyku kalitesinin bağımsız belirleyicileri olduğunu gösterdi. Sonuç: Hemodiyaliz hastalarında uyku bozuklukları, sistemik inflamasyon ve anemiyle yakından ilişkili olup, CRP ve hemoglobin düzeyleri kötü uyku kalitesinin güçlü bağımsız belirleyicileridir. Klinik uygulamada bu parametrelerin rutin izlenmesi ve inflamasyon ile anemiyi hedef alan müdahalelerin geliştirilmesi önerilir.

Keywords

• Hemodiyaliz
• uyku kalitesi
• CRP
• hemoglobin
• biyobelirteç

The relationshop between sleep quality and inflammatory and biochemical parameters in hemodialysis patients

Abstract

Aims: This study aimed to evaluate the relationship between sleep quality and inflammatory and biochemical parameters in hemodialysis patients. Methods: In this cross-sectional, single-center study conducted in January 2025, a total of 195 patients aged 18 and older who had been undergoing hemodialysis treatment for at least six months were included. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI); scores ≤5 were classified as “good sleep,” and >5 as “poor sleep.” Demographic, clinical, and laboratory data were retrospectively collected. Following univariate comparisons, logistic regression analysis was performed to determine independent predictors of poor sleep quality. Results: Poor sleep quality was observed in 55% of the patients. In the univariate analysis, CRP, leukocytes, and CRP/albumin ratio were higher in poor sleepers, while hemoglobin, albumin, and HALP scores were lower (p<0.05). Multivariate logistic regression analysis revealed that elevated CRP (OR 1.032; 95% CI 1.001–1.064; p=0.043) and low hemoglobin (OR 0.481; 95% CI 0.350–0.660; p<0.001) were independent predictors of poor sleep quality. Conclusion: Sleep disorders in hemodialysis patients are closely associated with systemic inflammation and anemia. CRP and hemoglobin levels are strong independent determinants of poor sleep quality. It is recommended that these parameters be routinely monitored in clinical practice and that interventions targeting inflammation and anemia be developed.

Keywords

• Hemodialysis
• sleep quality
• CRP
• hemoglobin
• biomarker

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