Evaluation of Allostatic Load as a Mediator of Sleep and Kidney Outcomes in Black Americans.
dc.contributor.author | Lunyera, Joseph | |
dc.contributor.author | Davenport, Clemontina A | |
dc.contributor.author | Jackson, Chandra L | |
dc.contributor.author | Johnson, Dayna A | |
dc.contributor.author | Bhavsar, Nrupen A | |
dc.contributor.author | Sims, Mario | |
dc.contributor.author | Scialla, Julia J | |
dc.contributor.author | Stanifer, John W | |
dc.contributor.author | Pendergast, Jane | |
dc.contributor.author | McMullan, Ciaran J | |
dc.contributor.author | Ricardo, Ana C | |
dc.contributor.author | Boulware, L Ebony | |
dc.contributor.author | Diamantidis, Clarissa J | |
dc.date.accessioned | 2019-05-08T13:48:21Z | |
dc.date.available | 2019-05-08T13:48:21Z | |
dc.date.issued | 2019-03 | |
dc.date.updated | 2019-05-08T13:48:20Z | |
dc.description.abstract | Introduction:Poor sleep associates with adverse chronic kidney disease (CKD) outcomes yet the biological mechanisms underlying this relation remain unclear. One proposed mechanism is via allostatic load, a cumulative biologic measure of stress. Methods:Using data from 5177 Jackson Heart Study participants with sleep measures available, we examined the association of self-reported sleep duration: very short, short, recommended, and long (≤5, 6, 7-8, or ≥9 hours per 24 hours, respectively) and sleep quality (high, moderate, low) with prevalent baseline CKD, and estimated glomerular filtration rate (eGFR) decline and incident CKD at follow-up. CKD was defined as eGFR <60 ml/min per 1.73 m2 or urine albumin-to-creatinine ratio ≥30 mg/g. Models were adjusted for demographics, comorbidities, and kidney function. We further evaluated allostatic load (quantified at baseline using 11 biomarkers from neuroendocrine, metabolic, autonomic, and immune domains) as a mediator of these relations using a process analysis approach. Results:Participants with very short sleep duration (vs. 7-8 hours) had greater odds of prevalent CKD (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.03-1.66). Very short, short, or long sleep duration (vs. 7-8 hours) was not associated with kidney outcomes over a median follow-up of 8 years. Low sleep quality (vs. high) associated with greater odds of prevalent CKD (OR 1.26, 95% CI 1.00-1.60) and 0.18 ml/min per 1.73 m2 (95% CI 0.00-0.36) faster eGFR decline per year. Allostatic load did not mediate the associations of sleep duration or sleep quality with kidney outcomes. Conclusions:Very short sleep duration and low sleep quality were associated with adverse kidney outcomes in this all-black cohort, but allostatic load did not appear to mediate these associations. | |
dc.identifier | S2468-0249(18)30347-4 | |
dc.identifier.issn | 2468-0249 | |
dc.identifier.issn | 2468-0249 | |
dc.identifier.uri | ||
dc.language | eng | |
dc.publisher | Elsevier BV | |
dc.relation.ispartof | Kidney international reports | |
dc.relation.isversionof | 10.1016/j.ekir.2018.12.005 | |
dc.subject | African Americans | |
dc.subject | kidney diseases | |
dc.subject | sleep | |
dc.subject | sleep deprivation | |
dc.title | Evaluation of Allostatic Load as a Mediator of Sleep and Kidney Outcomes in Black Americans. | |
dc.type | Journal article | |
duke.contributor.orcid | Lunyera, Joseph|0000-0002-9350-320X | |
duke.contributor.orcid | Stanifer, John W|0000-0001-6379-300X | |
duke.contributor.orcid | Boulware, L Ebony|0000-0002-8650-4212 | |
duke.contributor.orcid | Diamantidis, Clarissa J|0000-0001-8212-6288 | |
pubs.begin-page | 425 | |
pubs.end-page | 433 | |
pubs.issue | 3 | |
pubs.organisational-group | School of Medicine | |
pubs.organisational-group | Duke | |
pubs.organisational-group | Duke Clinical Research Institute | |
pubs.organisational-group | Institutes and Centers | |
pubs.organisational-group | Medicine, Nephrology | |
pubs.organisational-group | Medicine | |
pubs.organisational-group | Clinical Science Departments | |
pubs.organisational-group | Staff | |
pubs.organisational-group | Medicine, General Internal Medicine | |
pubs.organisational-group | Duke Science & Society | |
pubs.organisational-group | Initiatives | |
pubs.organisational-group | Institutes and Provost's Academic Units | |
pubs.organisational-group | Duke Global Health Institute | |
pubs.organisational-group | University Institutes and Centers | |
pubs.organisational-group | Biostatistics & Bioinformatics | |
pubs.organisational-group | Basic Science Departments | |
pubs.organisational-group | Population Health Sciences | |
pubs.organisational-group | Community and Family Medicine | |
pubs.publication-status | Published | |
pubs.volume | 4 |
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