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Short or Long Sleep Duration and CKD: A Mendelian Randomization Study
Open accessAbstract
Significance Statement Poor sleep is known to be related to kidney function impairment. Using the UK Biobank cohort, including individuals self-reporting regular sleep patterns of short, intermediate, or long duration, the authors found that short or long sleep duration was associated with higher prevalence of CKD. In the genetic analysis, the genetic risk score for short but not long sleep duration was significantly related to a higher risk of CKD stages 3–5, suggesting causal effects of short sleep duration on CKD. Two-sample Mendelian randomization analysis, using the independent meta-analysis results of kidney function from the CKDGen Consortium genome-wide association study, also showed significant causal estimates of short sleep duration on CKD. Clinicians may thus consider encouraging patients to avoid short-duration sleeping behavior to reduce the risk of CKD. Background Studies have found sleeping behaviors, such as sleep duration, to be associated with kidney function and cardiovascular disease risk. However, whether short or long sleep duration is a causative factor for kidney function impairment has been rarely studied. Methods We studied data from participants aged 40–69 years in the UK Biobank prospective cohort, including 25,605 self-reporting short-duration sleep (<6 hours per 24 hours), 404,550 reporting intermediate-duration sleep (6–8 hours), and 35,659 reporting long-duration sleep (≥9 hours) in the clinical analysis. Using logistic regression analysis, we investigated the observational association between the sleep duration group and prevalent CKD stages 3–5, analyzed by logistic regression analysis. We performed Mendelian randomization (MR) analysis involving 321,260 White British individuals using genetic instruments (genetic variants linked with short- or long-duration sleep behavior as instrumental variables). We performed genetic risk score analysis as a one-sample MR and extended the finding with a two-sample MR analysis with CKD outcome information from the independent CKDGen Consortium genome-wide association study meta-analysis. Results Short or long sleep duration clinically associated with higher prevalence of CKD compared with intermediate duration. The genetic risk score for short (but not long) sleep was significantly related to CKD (per unit reflecting a two-fold increase in the odds of the phenotype; adjusted odds ratio, 1.80; 95% confidence interval, 1.25 to 2.60). Two-sample MR analysis demonstrated causal effects of short sleep duration on CKD by the inverse variance weighted method, supported by causal estimates from MR-Egger regression. Conclusions These findings support an adverse effect of a short sleep duration on kidney function. Clinicians may encourage patients to avoid short-duration sleeping behavior to reduce CKD risk.
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“self-reported short or long sleep duration (often defined as <6 or 7 and >8 or 9 h, respectively) and poor sleep quality [Pittsburgh Sleep Quality Index (PSQI) > 5] may be consistently associated with adverse health outcomes”
From Sleep Duration/Quality with Health Outcomes: An Umbrella Review of Meta-Analyses of Prospective Studies (2022) · cites this paper as [3]
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“…more protected from confounding and bias than observational analyses, have suggested that short sleep may be harmful for specific health outcomes [16 – 20], but confirmation using supplementary approaches which account for time-varying effects, control for wide range of clinical and lifestyle…”
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“Previous studies have demonstrated associations between individual sleep factors and CKD development, such as sleep duration [5,6], chronotype [7], snoring [8], insomnia [9], and daytime dozing [10].”
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“The model could potentially assist primary care physicians in conveniently and quickly identifying the risk of depression in patients with CKD, enabling early intervention and improved prognosis.”
Yang, H., Hou, C., Chen, W., Zeng, Y., Qu, Y., Sun, Y., Hu, Y., Tang, X., & Song, H. (2024) · Phenomics · doi:10.1007/s43657-023-00144-8 · Cited by 4
“…tests (Jones et al. 2008), we did not find significantly affected diseases for the ‘short sleep duration’ pattern, while prior literatures, including those based on the UK Biobank, indicated associations of sleep duration with CVD (Daghlas et al. 2019) and kidney diseases (Park et al. 2020).”
Okeke, F. C., & Ugwuoke, U. T. (2024) · Cureus · doi:10.7759/cureus.68538 · Cited by 4
“This finding is consistent with a cross-sectional analysis conducted by Jiang and colleagues [29], as well as an observational cohort study conducted by Park et al. [30].”
BackgroundResultChen, S., Zhang, T., Gao, H., & Zhang, J. (2025) · Renal Failure · doi:10.1080/0886022x.2025.2461682 · Cited by 5
Geng, L., Qin, Y., Gao, Y., & Zhang, W. (2025) · International Urology and Nephrology · doi:10.1007/s11255-025-04518-x · Cited by 4
“A prospective study demonstrated that individuals who sleep less than 6 h per night were at a higher risk of developing proteinuria and experiencing a more rapid decline in renal function compared to those who sleep 8 h [12].”
Li, X., Chattopadhyay, K., Qian, X., Yu, J., Xu, M., Li, L., Sun, J., & Li, J. (2022) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s366064 · Cited by 4
Ren, X., Jiang, M., Han, L., & Zheng, X. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111494 · Cited by 4
Peng, N., & Li, S. (2023) · International Urology and Nephrology · doi:10.1007/s11255-023-03861-1 · Cited by 4
Lin, Y. N., Zhou, L. N., Liu, Z. R., Wang, Y., Li, S. Q., Lu, F. Y., Zhang, L., & Li, Q. Y. (2023) · Nature and Science of Sleep · doi:10.2147/nss.s411677 · Cited by 3
“A cutoff of 6 h of sleep has been shown to be associated with significant morbidity and mortality.(11,22,23) Thus, we categorized the patients into two groups: <6 h (n=77) and ≥6 hours (n=193).”
MethodModeling and feature assessment of the sleep quality among chronic kidney disease patients
Matharaarachchi, S., Domaratzki, M., Marasinghe, C., Muthukumarana, S., & Tennakoon, V. (2022) · Sleep Epidemiology · doi:10.1016/j.sleepe.2022.100041 · Cited by 4
Sleep Duration and Kidney Function – Does Weekend Sleep Matter?
Wu, C., Yang, P.-L., Kao, L., Liu, Y., Zheng, C., Chu, P., Lu, K., Chu, C., & Chang, Y.-T. (2024) · Nature and Science of Sleep · doi:10.2147/nss.s427687 · Cited by 3
“This finding aligned with previous studies that long sleep duration was associated with the prevalence and progression of CKD 6,15 and was verified in a longitudinal study.”
BackgroundResultAssociations of sleep disorders and autonomic dysfunction with cardio-renal function
Kadoya, M., & Koyama, H. (2024) · Sleep And Breathing · doi:10.1007/s11325-024-03168-0 · Cited by 3
“Additionally, poor sleep quality has been associated with an increased risk of renal function decline [ 58–60], and a retrospective study indicated an association between sleep condition and CKD in individuals without OSA [61].”
Self-reported and objective sleep duration in patients with CKD: are they telling the same story?
de Carvalho, K. S. B., Lauar, J. C., Drager, L. F., Moysés, R. M. A., & Elias, R. M. (2022) · Brazilian Journal of Nephrology · doi:10.1590/2175-8239-jbn-2022-0015en · Cited by 3
Sleep duration and risk of mortality from chronic kidney disease among Japanese adults
Guo, S., Yamagishi, K., Kihara, T., Muraki, I., Tamakoshi, A., & Iso, H. (2024) · Sleep Health · doi:10.1016/j.sleh.2024.10.002 · Cited by 2
Zhang, Z., Niu, J., Sun, W., Sun, Y., Tan, Y., & Yu, J. (2025) · Renal Failure · doi:10.1080/0886022x.2024.2438848 · Cited by 4
“A Mendelian randomization study [6] showed that short sleep duration increases the risk of developing chronic kidney disease.”
Kim, J.-H., Ha, M. J., Choi, D., & Park, S. (2025) · Annals of Medicine · doi:10.1080/07853890.2025.2569986 · Cited by 2
“However, investigations suggest that excessive sleep length may be correlated with a higher occurrence of sleep fragmentation [41], obstructive sleep apnoea, snoring, which may negatively impact kidney function [42,43].”
Han, M., Qu, Y., Zeng, M., Gu, Z., Zhang, Y., Fan, T., Yang, Q., Wang, Z., Gao, P., Chen, S., et al. (2026) · Geriatric Nursing · doi:10.1016/j.gerinurse.2026.103834 · Cited by 2
Cho, J. M., Koh, J. H., Kim, S. G., Lee, S., Kim, Y., Cho, S., Kim, K., Kim, Y. C., Han, S. S., Lee, H., et al. (2023) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16355 · Cited by 2
Li, W., He, X., Liu, Y., Nie, D., Zhang, T., & Tan, C. (2024) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.33012 · Cited by 2
Li, M., Xiao, H., Amaerjiang, N., Thapa, B., Shu, W., Asihaer, Y., Guan, M., Vermund, S. H., Zou, Z., Huang, D., et al. (2024) · Nutrients · doi:10.3390/nu16203472 · Cited by 2
“…dehydration compared to optimal sleep duration [17], and studies further suggest a dyadic disruption of homeostatic systems linked to sleep and hydration [7–9 , In this longitudinal study, we investigated transient renal tubular and glomerular impairment in an ongoing child cohort (PROC) study.”
BackgroundResultInfluentialZheng, Y., Zhao, L., Zheng, Y., Bai, W., Lai, X., Yang, L., Zhang, X., & Liu, M. (2024) · Hygiene and Environmental Health Advances · doi:10.1016/j.heha.2024.100116 · Cited by 2
Association between Age of Onset of Hypertension and Risk of CKD
Lu, X., Chen, D., Kang, L., Sun, L., Xie, X., Tan, X., Meng, Y., Lei, F., Sun, T., & Chen, J. (2025) · Kidney360 · doi:10.34067/kid.0000000872 · Cited by 3
Big Data Analysis of the Relationship between Sleep Duration, Hyperuricemia, and Hypertension
戴秀珍, 戴., Tai, S.-H. H. H.-C., Huang, Y.-C. H. S.-H., Huang, W.-C. C. Y.-C., & Chien, I.-L. L. W.-C. (2022) · 網際網路技術學刊 · doi:10.53106/160792642022092305008 · Cited by 2
Zheng, G., Ou, F., Chen, S., Ji, C., Chang, Q., Wang, D., Yang, H., Ma, Z., Xia, Y., & Zhao, Y. (2025) · The Journals of Gerontology Series A · doi:10.1093/gerona/glaf187 · Cited by 1
Zhang, J. B., Liu, B., Han, J., & Gu, X. (2025) · Medicine · doi:10.1097/md.0000000000045368 · Cited by 1
“In the context of kidney-related outcomes, Park et al [29] conducted an MR study exploring the causal effects of sleep traits on CKD.”
Cao, B., Ma, B., Deng, Z., & Wen, S. (2025) · Scientific Reports · doi:10.1038/s41598-025-32994-9 · Cited by 1
Good sleep for healthy kidneys
Nadkarni, G. N. (2020) · Science Translational Medicine · doi:10.1126/scitranslmed.abe8124 · Cited by 1
Duração do sono autorrelatada e objetiva em pacientes com DRC: contam a mesma história?
de Carvalho, K. S. B., Lauar, J. C., Drager, L. F., Moysés, R. M. A., & Elias, R. M. (2022) · Brazilian Journal of Nephrology · doi:10.1590/2175-8239-jbn-2022-0015pt · Cited by 1
Zhang, J., Yu, H., Jiao, L., Wang, D., Wu, H., Meng, G., Wu, H., Wu, X., Zhu, D., Chen, Y., et al. (2025) · Rejuvenation Research · doi:10.1089/rej.2024.0058 · Cited by 1
“16 Several MR studies using sleep traits as exposure factors had demonstrated causal associations between genetically determined sleep traits and the risk of developing CVD, 17 cancers, 18 renal function, 19 and psychiatric disorders, 20 etc.”
Pacheco, A. L. O., Rodrigues, H. C. N., Preto, V. R. M., Cunha, L. N. P., de Oliveira, S. V., dos Santos, M. F., & Costa, N. A. (2025) · Nutrire · doi:10.1186/s41110-025-00322-w · Cited by 1
“Lack of regular moderate exercise, eating late at night, snacking before bed, and short ( 6 h) or long (≥ 9 h) sleep time were the main habits reported [17, 18].”
Quan, J., Chen, L., Chen, W., Gong, Z., Li, S., Chen, H., Huang, Z., & Yi, B. (2025) · Renal Failure · doi:10.1080/0886022x.2025.2478320 · Cited by 1
“Evidence indicates that both short sleep and insomnia increase the risk of kidney injury [18,20,37], while excessively long sleep may also compromise renal function [19].”
Zhang, X., Zhang, S., Lv, J., Ma, X., Lin, X., Yang, L., Li, S., & Zhang, T. (2025) · Healthcare · doi:10.3390/healthcare13070703 · Cited by 1
“Furthermore Furthermore, prospective cohort studies using data from UK Biobank [11,21,33] consistently demonstrate an inverse association between adherence to healthy sleep behaviors and CKD risk.”
Wang, K., Ye, S., Feng, H., Liang, Y. Y., Guo, S. J., Zheng, R., Zhou, Y., Jia, G., Qi, L., Zhao, G., et al. (2025) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2024.12.020 · Cited by 1
Metadata
- Authors
- Park, S., Lee, S., Kim, Y., Lee, Y., Kang, M. W., Kim, K., Kim, Y. C., Han, S. S., Lee, H., Lee, J. P., Joo, K. W., Lim, C. S., Kim, Y. S., & Kim, D. K.
- Affiliations
- Seoul National University (KR)
- Seoul National University Hospital (KR)
- ORCID
- Venue
- Journal of the American Society of Nephrology
- Published
- 2020-10-01
- Volume
- 31
- Issue
- 12
- Pages
- 2937-2947
- ISSN
- 1046-6673 (ISSN-L)
- 1533-3450
- PMC
- PMC7790216
- OpenAlex
- W3090993883
- Cited by
- 123
- References
- 34
- Citations by year
- 2026: 5 · 2025: 27 · 2024: 24 · 2023: 24 · 2022: 24 · 2021: 16 · 2020: 3
- FWCI
- 16.20
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Society of Nephrology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Seoul National University Open Repository (Seoul National University) (submittedVersion)
- Funders
- Ministry of Trade, Industry & Energy (10077474)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Keywords
- short sleep duration, long sleep, chronic kidney disease, sleep duration, renal function, causal effects, polygenic risk score, sleep behavior, CKD stages 3-5, UK Biobank, genetic instruments, cardiovascular risk
- MeSH terms
- Adult, Aged, Female, United Kingdom, Humans, Male, Middle Aged, Sleep, Time Factors, Cohort Studies, Prevalence, Logistic Models, Odds Ratio, Renal Insufficiency, Chronic, Mendelian Randomization Analysis
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