Association between Sleep Duration Trajectory and Risk of Chronic Kidney Disease: A 9-Year Follow-Up Survey in China

Limited studies have explored the link between sleep duration and chronic kidney disease (CKD). However, the longitudinal alteration of sleep duration over time, known as sleep duration trajectories, has not been well explored. This gap results in an unclear understanding of the relationship between sleep duration trajectories and the risk of developing CKD, which is addressed in this study.

Based on longitudinal data from the China Health and Retirement Longitudinal Study (2011, 2013, and 2015 waves), a group-based trajectory model was used to identify distinct patterns of sleep duration. A Cox proportional hazards model was employed to assess the hazard ratios associated with each trajectory in relation to CKD onset (2018 and 2020 waves). Additionally, interaction analysis was conducted to examine potential individual-level modifiers of the relationship between sleep duration trajectories and CKD onset. Three different sensitivity analyses were performed to ensure the robustness of the findings.

A total of 11,059 individuals were included in this survey with three distinct sleep duration trajectories identified: Group 1 (mean sleep duration: 3.56 ± 1.32), Group 2 (mean sleep duration: 5.83 ± 1.36), and Group 3 (mean sleep duration: 7.70 ± 1.17). Group 1 showed the highest risk of developing CKD, with an incidence of 10.54 cases per 1,000 person-years (95% confidence interval 8.77-12.68). Relative to group 1, group 3 was significantly associated with a reduced risk of CKD (hazard ratio 0.55, 95% confidence interval 0.44-0.70). A notable decrease in CKD risk was observed across all subgroups, and no significant interaction effects were found between covariates and the association between sleep duration trajectory and CKD.

Among middle-aged and elderly adults, persistent long sleep duration was associated with a lower risk of CKD. Maintaining adequate and stable sleep duration may be beneficial for CKD risk management in this population. However, further evidence is required to inform definitive public health recommendations.