Kronik Böbrek Hastalığı Olan Hastalarda Kötü Uyku Kalitesiyle İlgili Faktörlerin Böbrek Yetmezliğinin İlerlemesine Etkisi

Öz

Amaç: Son yıllarda, diyaliz öncesi KBH olan hastalarda uyku kalitesini karakterize etmek için sınırlı çalışmalar denenmiştir ve kanıtlar, yetersiz uyku süresinin veya düşük kaliteli uykunun KBH'nin ilerlemesine yol açtığını göstermiştir. Bu çalışmada kronik böbrek hastalarında kötü uyku kalitesi ile ilişkili faktörleri belirlemeyi ve bu faktörlerin böbrek progresyonu üzerindeki etkilerini değerlendirmeyi amaçladık. Gereç ve yöntemler: Çalışmaya kardiyovasküler hastalığı olmayan, obstrüktif uyku apnesi ve aktif enfeksiyonu olmayan 18 yaş ve üzeri prediyaliz KBH (Evre 3-5) hastalar alınarak Haziran 2015 - Kasım 2015 tarihleri arasında izlenmeye başlandı. Bu hastaların uyku kalitesi Pittsburgh uyku kalitesi indeksi (PUQI) kullanılarak ölçüldü. 4 yıllık takip sonunda hastaların birincil sonlanmaları ESRD, ESRD + mortalite ve progresyon (GFH'de 25 ml / dk azalma) olarak kabul edildi. Bulgular: Çalışmada izlenen 179 hastadan 107'si (% 59,8) iyi uyku kalitesine, 72'si (% 40,2) kötü uyku kalitesine sahipti. Kötü uyku kalitesinin bağımsız belirteçlerini tespit etmek için yapılan Binary Logistic Regression analizinde; yaşlılık ve kadın cinsiyetin kötü uyku kalitesinin bağımsız belirleyicisi olduğu bulundu. Kötü uyku kalitesinin ESRD, ESRD + Mortalite ve GFR≥ 25 ml / dk azalma gibi renal progresyon koşullarını etkilemediği bulundu. Sonuç: Sonuç olarak, yaş ve kadın cinsiyetin kötü uyku kalitesinin bağımsız belirleyicileri olduğunu ve kötü uyku kalitesinin mortaliteyi artırdığını belirledik. Anahtar Kelimeler: Uyku kalitesi, kronik böbrek hastalığı, progresyon

Anahtar Kelimeler

• Uyku kalitesi
• kronik böbrek hastalığı
• progresyon

The Effect of Factors Related to Poor Sleep Quality on Renal Failure Progression in Patients with Chronic Kidney Disease

Öz

Aim: In recent years, limited studies have been attempted to characterize the quality of sleep in patients with predialysis CKD, and the evidence has shown that insufficient sleep time or poor-quality sleep lead to the progression of CKD. In this study, we aimed to determine the factors related to poor sleep quality in chronic kidney patients and evaluate the effects of these factors on renal progression. Materials and Methods: Patients with pre-dialysis CKD (E3-E5) over 18 years of age who did not have cardiovascular disease, obstructive sleep apnea, and active infection, started to be followed between June 2015 and November 2015, were included in the study. The sleep quality of these patients was measured using the Pittsburgh sleep quality index (PSQI). At the end of the 4-year follow-up, the primary outcomes of the patients were accepted as ESRD, ESRD + mortality, and progression (25 ml/min reduction in GFR). Results: Of the 179 patients followed in the study, 107 (59.8%) had good sleep quality, 72 (40.2%) had poor sleep quality. In the Binary Logistic Regression analysis performed to detect independent markers of poor sleep quality; old age and female gender were found to be independent predictors of poor sleep quality. It was found that poor sleep quality did not affect renal progression conditions such as ESRD, ESRD + Mortality, and GFR≥ 25 ml/min decrease. Conclusion: As a result, we determined that age and female gender are independent determinants of poor sleep quality and poor sleep quality increases mortality.

Anahtar Kelimeler

• sleep quality
• chronic kidney disease
• progression

Kaynakça

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