Longer Time Spent In Bed Attempting To Sleep Is Associated With Rapid Renal Function Decline:The Dongfeng-Tongji Cohort Study

Objectives:There were amounts of cross-sectional studies reporting the associations of longer or shorter sleep durations with renal dysfunction.However,prospective evidence on the relation between time in bed and renal dysfunction remains limited,especially in Chinese.We aimed to investigate the association of time spent in bed attempting to sleep(TSBS)with renal function decline in a middle-aged and elderly Chinese population.Methods:The study was based on the Dongfeng-Tongji(DFTJ)cohort study,which enrolled 27,009 participants from Dongfeng Motor Corporation,Shiyan city,Hubei province from 2008 to 2010.The baseline surveys included questionnaire,physical examination,biochemical examination and collection of blood samples.In our study,after excluding participants with cancer or kidney disease at baseline,16,733 eligible participants with a mean age of 62.3 years at baseline were included.Rapid renal function decline was defined as(baseline eGFR-revisit eGFR)/years of follow-up≥5m L/min per 1.73 m~2/year.A total of 1,738 study participants experienced rapid renal function decline after a median 4.6-year follow-up.We performed multivariate logistic regression analysis to evaluate the association between TSBS and the risk for rapid renal function decline.Results:1.We analyzed the association of TSBS with rapid renal function decline.The adjusted odds ratio(OR)of rapid renal function decline was 1.18(95%CI:1.02,1.37)for TSBS≥9h/night compared with TSBS 7-<8h/night.This association remained significant(OR=1.19,95%CI:1.03,1.38)after further adjustment for sleep quality,midday napping and usage of sleeping pills.2.We further conducted stratified analysis in our study.Particularly,the association appeared to be prominent in individuals who were physical active,nonsmokers,nondrinkers,without diabetes,coronary heart disease and stroke.However,a significant interaction was only found between TSBS and diabetes(P for interaction<0.001).In the non-diabetes,participants reported TSBS≥9h had 20%increased risk of rapid renal function decline compared to those with TSBS 7-<8h,but TSBS≥9h was not significantly related to rapid renal function decline in the diabetes.Conclusions:Longer TSBS(≥9h)was independently associated with an increased risk of rapid renal function decline.