Hemodialysis-induced chronodisruption and chronotype distribution in patients with chronic kidney disease

ABSTRACT

Changes in circadian rhythms have been observed in patients with chronic kidney disease (CKD), and evidence suggests that these changes can have a negative impact on health. This study aimed to investigate the existence of hemodialysis-induced chronodisruption, the chronotype distribution, and their association with sleep quality and quality of life (QoL). This was a cross-sectional study that enrolled 165 patients (mean age: 51.1 ± 12.5 y, 60.6% male) undergoing hemodialysis from three local units. The following instruments were used: the Morning-Eveningness Questionnaire (MEQ); a modified version of the Munich Chronotype Questionnaire (MCQT) to estimate hemodialysis-induced chronodisruption (HIC); the Kidney Disease QoL Short Form (KDQOL-SF); the Epworth Sleepiness Scale (ESS); the Pittsburgh Sleep Quality Index (PSQI) and the 10–Cognitive Screener (10-CS). HIC was present in 40.6% of CKD patients. Morning chronotype was prevalent in CKD patients (69%) compared to evening-type (17.1%) and significantly different from a paired sample from the general population (p < 0.001). HIC and chronotype were associated with different domains of QoL but not with sleep quality. This study suggests that there is a HIC and that morning chronotype is associated with CKD patients undergoing hemodialysis, with implications for QoL.

KEYWORDS:

• Chronodisruption
• chronotype
• hemodialysis
• sleep
• chronic kidney disease
• quality of life

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

All authors contributed to the study conception and design (Nunes PP, Andrade TG, Gitaí LLG, Teles F); and/or the acquisition, analysis or interpretation of data (Nunes PP, Resende CM, Silva EDB, Monteiro LN, Bastos DCP, Ramires Filho MLM, Silva RL, Andrade TG, Gitaí LLG, Teles F); and/or made substantial contributions in writing and reviewing the manuscript (Leocadio-Miguel MA, Pedrazzoli M, Sobreira-Neto MA, Andrade TG, Gitaí LLG, Teles F).

Ethics approval

The study was approved by the Institutional Ethics Committee of Federal University of Alagoas and all patients have signed written informed consent to participate and to publish prior to enrolment in the study.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.