Chronotype evaluation in patients with chronic kidney disease on hemodialysis
Chronic Renal Failure, Circadian Rhythm Sleep Disorders, hemodialysis.
INTRODUCTION: The prevalence of sleep disorders is higher in patients with
kidney disease (CKD) than in the general population. These patients when on hemodialysis
are distributed in treatment shifts that constitute an appointment that occurs
three times a week, and that can interfere with the sleep-wake cycle. Changes in rhythms
have been observed in patients with CKD and there is accumulated evidence of
that some of them can negatively affect health. Cronodiseruption refers to the
chronic interruption of circadian rhythms leading to the disease. Changes in the cycle
sleep-wakein in hemodialysis patients impact on quality of life and may
endogenous circadian rhythms. Social jet lag is a term that describes the
misalignment between social and biological times conventionally opposing days of
work free days. OBJECTIVE: To investigate whether there is social Jet Lag related to
hemodialysis, assess the chronotype of chronic renal patients on haemodialysis and whether there is
inconsistency between the chronotype and the dialysis shift. METHODS: A total of 194
hemodialysis patients from three local dialysis units were enrolled in February
june 2022. The chronotype was estimated using morning-eveningness
Questionnaire (MEQ) and a modified version of the Munich Chronotype Questionnaire
(MCQT) was used to estimate the social Jet Lag related to hemodialysis.
RESULTS: Hemodialysis-related jet lag was 48.1 ± 1.4 min (range 0 -
4:57) and was inversely correlated with age (r=-0.216, p=0.01). The chronotype was
distributed in 2.1% moderately related, 31.4% intermediate, 39.2%
moderately morning and 27.3% definitely in the morning. Forty-four
patients (22.7%) were being treated in the morning shift, 96 (49.5%) in the
afternoon and 54 (27.8%) in the night shift. The inconsistency between the treatment shift and the
chronotype was detected in 38 (19.6%) and was related to higher scores of the
MEQ (p<0.001). CONCLUSION: Therefore, this study seems to indicate that there may be
hemodialysis-related social jet lag, that morning chronotype is the most frequent
in hemodialysis patients and the highest MEQ score is related to
inconsistency between the shift and the chronotype.