Back
Chronic Kidney Disease (CKD) and its treatment could be associated with chronotype (CT, a sleep/wake behavior pattern determined by the circadian rhythm). Evening CT has been associated with unhealthy diets and metabolic disturbances in some chronic diseases; however, it has been scarcely studied in CKD. Objective: To assess the association between CT and the nutritional status of patients with CKD.
Methods: Analytical cross-sectional study, with 114 CKD patients included; all of them had clinical and nutritional evaluation. Diet quality was assessed with the Mini-ECCA v.2 survey, and CT with the Morningness-Eveningness Questionnaire (rMEQ). Protein Energy Wasting (PEW) was determined by means of Subjective Global Assessment (SGA) and body composition by spectroscopic impedance. Statistical analysis: Spearman's correlation coefficient and multivariate analysis with binary logistic regression.
Forty-eight percent of patients had a morning CT, 37% intermediate, and 15% evening. The comparison between groups is shown in the table. In predialysis, greater morningness was associated with older age (r=0.39, p=0.04), higher systolic pressure (r=0.46, p=0.02), and lower consumption of sugary drinks (r=0.42, p=0.002). In hemodialysis, greater morningness was associated with older age (r=0.37, p=0.003), higher SGA score (r=0.34, p=0.03), and higher hemoglobin (r=0.34, p=0.05). There were no variables associated with CT in patients on peritoneal dialysis nor in transplantation. In the multivariate analysis, the variables predicting morningness (R2=0.19, p=0.001) were age [B=0.15 (0.06 – 0.19) <0.0001] and percentage of fat-free mass [B=0.06 (0.003 – 0.12)].
Conclusions: A morning CT was associated with older age and better nutritional status indicators in predialysis and hemodialysis patients but not in those on peritoneal dialysis and transplantation.