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Dehydration and Suboptimal Sleep Aggravate Early Renal Impairment in Children: Longitudinal Findings from the PROC
Menglong Li1, Huidi Xiao1, Nubiya Amaerjiang1
1Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China.
Insights
Dehydration and poor sleep in children increase the risk of temporary kidney damage. Maintaining adequate hydration and sufficient sleep is crucial for pediatric kidney health.
Area of Science:
- Pediatric Nephrology
- Sleep Medicine
- Public Health
Background:
- Dehydration is a known risk factor for pediatric renal impairment.
- Sleep patterns can influence hydration status, but their combined effect on kidney health is not well understood.
Purpose of the Study:
- To investigate the longitudinal associations between sleep duration, hydration status, and transient renal impairment in primary school children.
Main Methods:
- A cohort study of 1914 healthy children in Beijing, China.
- Assessed urinary biomarkers (β2-microglobulin, microalbumin) for renal impairment and specific gravity for hydration.
- Utilized generalized linear mixed-effects models to analyze associations with sleep duration and hydration.
Main Results:
- Children with suboptimal sleep (short or long duration) and dehydration showed significantly higher odds of transient tubular and glomerular impairment.
- Even with euhydration, long sleep duration was associated with increased risk of tubular impairment.
- Optimal sleep combined with dehydration also elevated the risk for both tubular and glomerular impairment.
Conclusions:
- Both dehydration and inadequate sleep duration are significant risk factors for transient renal impairment in children.
- These findings highlight the importance of adequate sleep and hydration for maintaining pediatric kidney health.
Background:
While dehydration is associated with pediatric renal impairment, the regulation of hydration status can be affected by sleep. However, the interaction of hydration and sleep on kidney health remains unclear.
Methods:
We conducted a cohort study among 1914 healthy primary school children from October 2018 to November 2019 in Beijing, China. Four-wave urinary β2-microglobulin and microalbumin excretion were assayed to assess transient renal tubular and glomerular impairment, and specific gravity was measured to determine hydration status with contemporaneous assessment of sleep duration, other anthropometric, and lifestyle covariates. We used generalized linear mixed-effects models to assess longitudinal associations of sleep duration and hydration status with renal impairment.
Results:
We observed 1378 children with optimal sleep (9-<11 h/d, 72.0%), 472 with short sleep (<9 h/d), and 64 with long sleep (≥11 h/d, 3.3%). Over half (55.4%) of events determined across 6968 person-visits were transient dehydration, 19.4% were tubular, and 4.9% were glomerular impairment events. Taking optimal sleep + euhydration as the reference, the results of generalized linear mixed-effects models showed that children with long sleep + dehydration (odds ratio [OR]: 3.87 for tubular impairment [tubules] and 3.47 for glomerular impairment [glomerulus]), long sleep + euhydration (OR: 2.43 for tubules), optimal sleep + dehydration (OR: 2.35 for tubules and 3.00 for glomerulus), short sleep + dehydration (OR: 2.07 for tubules and 2.69 for glomerulus), or short sleep + euhydration (OR: 1.29 for tubules) were more likely to present transient renal impairment, adjusting for sex, age, body mass index z-score, systolic blood pressure z-score, screen time, physical activity, and Mediterranean diet adherence.
Conclusions:
Dehydration and suboptimal sleep aggravate transient renal impairment in children, suggesting its role in maintaining pediatric kidney health.
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