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Updated: Jul 4, 2025
Human Circadian Phenotyping and Diurnal Performance Testing in the Real World
Published on: April 7, 2020
Hemodialysis-induced chronodisruption and chronotype distribution in patients with chronic kidney disease
Patrícia Pereira Nunes1, Caroline Meneses Resende1, Ellen Dayanne Barros Silva1
1Faculty of Medicine, Federal University of Alagoas, Maceió, Brazil.
Insights
Hemodialysis disrupts circadian rhythms in 40.6% of chronic kidney disease (CKD) patients, affecting their quality of life. Morning chronotype is prevalent, differing significantly from the general population.
Area of Science:
- Chronobiology
- Nephrology
- Sleep Medicine
Background:
- Circadian rhythm disturbances are common in chronic kidney disease (CKD) patients.
- These disruptions are linked to adverse health outcomes, necessitating further investigation.
- The impact of hemodialysis on circadian timing and its consequences remain underexplored.
Purpose of the Study:
- To investigate hemodialysis-induced chronodisruption (HIC) in CKD patients.
- To determine the chronotype distribution among hemodialysis patients.
- To assess the association between HIC, chronotype, sleep quality, and quality of life (QoL).
Main Methods:
- A cross-sectional study involving 165 hemodialysis patients.
- Utilized validated questionnaires: MEQ, MCQT (modified for HIC), KDQOL-SF, ESS, PSQI, and 10-CS.
- Statistical analysis to evaluate HIC prevalence, chronotype distribution, and associations with QoL and sleep.
Main Results:
- Hemodialysis-induced chronodisruption (HIC) was present in 40.6% of patients.
- A morning chronotype was prevalent (69%) in CKD patients, significantly differing from the general population.
- HIC and chronotype were associated with specific domains of Quality of Life (QoL), but not sleep quality.
Conclusions:
- Hemodialysis-induced chronodisruption (HIC) is a significant issue in CKD patients.
- The prevalence of morning chronotype in this population warrants attention.
- Circadian rhythm alterations in hemodialysis patients have implications for their overall Quality of Life (QoL).
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.
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