Evidence map›Paper›PMID 40475303›Full record

ArticleKidney medicine2025

Sleep Patterns, Symptoms, and Mortality in Hemodialysis: A Prospective Cohort Study.

Yoko Narasaki, Amy S You, Ira Kurtz, Niloofar Nobakht, Mohammad Kamgar, Man Kit Michael Siu, Rebecca S Ahdoot, Ramy Hanna, Sara S Kalantar, Jihoon Yoon and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Kidney medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Yoko NarasakiDivision of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
Amy S YouDivision of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
Ira KurtzDivision of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
Niloofar NobakhtDivision of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
Mohammad KamgarDivision of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
Man Kit Michael SiuDivision of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
Rebecca S AhdootDepartment of Medicine, University of California Irvine School of Medicine, Orange, CA.
Ramy HannaDepartment of Medicine, University of California Irvine School of Medicine, Orange, CA.
Sara S KalantarSchool of Public Health, University of California Berkeley, Berkeley, CA.
Jihoon YoonDivision of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
Lisa LeDivision of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
Silvina Torres RiveraDivision of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
Tracy NakataDepartment of Medicine, University of California Irvine School of Medicine, Orange, CA.
Ria AroraDepartment of Medicine, University of California Irvine School of Medicine, Orange, CA.
Danh V NguyenDepartment of Medicine, University of California Irvine School of Medicine, Orange, CA.
Kamyar Kalantar-ZadehDepartment of Medicine, University of California Irvine School of Medicine, Orange, CA.
Connie M RheeDivision of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.

Funding

Multilevel Time-Dynamic Modeling of Hospitalization and Survival in Patients on DialysisR01DK092232 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KURUM, ESRA, NGUYEN, DANH V · 2011 to 2025
$4.9M
A Randomized Controlled Trial of Thyroid Hormone Supplementation in Hemodialysis PatientsR01DK122767 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI RHEE, CONNIE MEEYOUNG · 2019 to 2023
$3.3M
Defining Optimal Transitions of Care in Advanced Kidney Disease: Conservative Management vs. Dialysis ApproachesR01DK124138 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KALANTAR-ZADEH, KAMYAR, RHEE, CONNIE MEEYOUNG · 2020 to 2024
$2.9M
MALNUTRITION, DIET AND RACIAL DISPARITIES IN CKDK24DK091419 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI KALANTAR-ZADEH, KAMYAR · 2011 to 2020
$1.8M
Plant-Focused Nutrition in Patients with Diabetes and Chronic Kidney Disease (PLAFOND Study): A Pilot/Feasibility StudyR01DK132875 · NIDDK · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI KALANTAR-ZADEH, KAMYAR, RHEE, CONNIE MEEYOUNG · 2023 to 2025
$836k
Continuous Glucose Monitoring in Dialysis Patients to Overcome Dysglycemia Trial (CONDOR TRIAL)R01DK132869 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KALANTAR-ZADEH, KAMYAR, RHEE, CONNIE MEEYOUNG · 2023 to 2025
$781k
NIDDK NIH HHS K24 DK091419NIDDK NIH HHS R01 DK092232NIDDK NIH HHS R01 DK122767NIDDK NIH HHS R01 DK124138NIDDK NIH HHS R01 DK132869NIDDK NIH HHS R01 DK132875
6 · The paper itself

Abstract

Rationale & Objective: While sleep disorders are common in patients treated with hemodialysis, the impact of sleep patterns on survival is not well defined. We thus examined the association of specific sleep patterns with mortality in this population. Study Design: An observational cohort study. Setting & Population: In-center hemodialysis patients from the multicenter prospective NIH Malnutrition, Diet, and Racial Disparities in Chronic Kidney Disease (MADRAD) cohort. Exposure: Sleep patterns ascertained using protocolized sleep surveys from March 2014 to June 2019. Outcomes: Mortality. Analytical Approach: Cox proportional hazards models. Results: Among 452 participants, the mean age was 55±14 years, among whom 46% were women and the median follow-up was 3.5 years. In expanded case-mix models, shorter sleep duration (≤ median of observed values) was associated with higher mortality on dialysis and nondialysis days (ref: > median): HRs (95% CIs) 1.59 (1.09-2.31) and 1.51 (1.04-2.19), respectively. Patients who reported high frequencies (often/almost always) of difficulty falling asleep, feeling unrested, fatigue/exhaustion post-dialysis, or fatigue/exhaustion on nondialysis days had higher mortality (ref: never/rarely having these symptoms): HRs (95% CIs) 1.74 (1.17-2.58), 1.69 (1.1-2.5), 2.42 (1.41-4.16), and 1.73 (1.11-2.69), respectively. Moderate to high frequency of sleeping pill use was associated with higher mortality (ref: never/rare use): HRs (95% CIs) 2.07 (1.08, 3.97) and 2.00 (1.22, 3.28) for sometimes and often/almost always using sleeping pills, respectively. Sleeping outside of the primary sleep period (intra-dialytic sleeping and napping) was not associated with worse survival. However, patients reporting frequent apnea or restless legs syndrome had higher mortality. Limitations: Potential recall bias, residual confounding, absence of time-varying observations, and limitations in generalizability. Conclusions: In a well-characterized prospective multicenter hemodialysis cohort, patients who reported shorter sleep duration, sleeping difficulty or feeling unrested, moderate to frequent sleeping pill consumption, and sleep disorders (apnea and restless legs) had a higher mortality risk.

Indexed as

dialysisend-stage kidney diseaseSleep disorderssleep patternssymptom managementunpleasant symptoms

Identifiers

PMID40475303
PMCPMC12139240

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.