Background: Poor sleep quality, a novel risk factor of cardiovascular diseases (CVD), is highly prevalent in patients\nwith chronic kidney disease (CKD). The association between poor sleep quality and cardiovascular damage in\npatients with CKD is unclear. This study is aimed to assess the prevalence and related risk factors of sleep\ndisturbance and determine the relationship between sleep quality and cardiovascular damage in Chinese patients\nwith pre-dialysis CKD.\nMethods: A total of 427 pre-dialysis CKD patients (mean age = 39 �± 15 years, 260 male/167 female) were recruited\nin this study. The demographics and clinical correlates were collected. The sleep quality was measured by the\nPittsburgh Sleep Quality Index (PSQI), whereas the cardiovascular damage indicators (the Early/late diastolic\npeak flow velocity (E/A) ratio and left ventricular mass index (LVMI)) were determined by an echocardiographic\nexamination.\nResults: Of the CKD patients, 77.8% were poor sleepers as defined by a PSQI score > 5. Median estimated\nglomerular filtration rate (eGFR) was 69.4(15.8-110.9) ml/min/1.73 m2. Logistic regression analysis revealed that left\nventricular hypertrophy (LVH) was independently associated with the PSQI score (OR = 1.092, 95% CI = 1.011-1.179,\np = 0.025), after adjustment for age, sex and clinical systolic blood pressure, diastolic blood pressure, Phosphate,\nIntact parathyroid hormone (iPTH), Hemoglobin and eGFR. The linear regression analysis showed that the E/A ratios\nwere independently associated with the PSQI score (? = ?0.115, P = 0.028) after adjustment for a series of potential\nconfounding factors.\nConclusions: Poor sleep quality, which is commonly found in pre-dialysis CKD patients, is an independent factor\nassociated with cardiovascular damage in CKD patients. Our finding implies that the association between poor sleep\nand CVD might be mediated by cardiac remodeling.
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