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Background: The purpose of this study was to explore the separate and combined associations of obstructive sleep apnea (OSA) risk and sleep duration with ideal cardiovascular health metrics in hemodialysis (HD) patients. Methods: 470 HD participants (average: 59.48 ± 12.89 y, 281 men) were included in this study. Sleep duration was measured as self-reported average sleep time during the previous month. The OSA risk was assessed using the STOP-BANG questionnaire. Participants were divided into three groups based on the number of ideal cardiovascular health (CVH) metrics: 0–2,3–4, and 5–7. Ordinal logistic regression was conducted to model the associations of CVH metrics with sleep duration, OSA risk, and their combined effects by adjusting for specific covariates. Results: After adjusting for covariates, short sleep duration (< 7 h) (OR = 0.53; 95% CI [ 0.30, 0.92]) and OSA risk (OR = 0.58; 95% CI [0.32, 0.83]) were negatively associated with better CVH (ideal vs. intermediate; intermediate vs. poor), respectively. For HD patients with both short sleep duration and OSA risk, the odds of ideal CVH metrics were reduced by 72% (odds ratio 0.28 [95% CI 0.13, 0.60]). Conclusions: Short sleep duration and OSA risk are separately and jointly associated with poor CVH in hemodialysis patients. Suitable interventions for sleep may minimize the risk of developing cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background: Patients undergoing hemodialysis are highly predisposed to arterial disease, poor physical performance, and cognitive impairment. However, the connection between them is not yet known. We aimed to investigate the mediating effect of physical performance on the relationship between arterial stiffness and mild cognitive impairment (MCI). Methods: We conducted a multicenter cross‐sectional study. The final analyzed hemodialysis patients comprised 616 subjects (men 391, women 225) from seven dialysis units in Shanghai, China. MCI was assessed by Mini‐Mental State Examination (MMSE) and the Instrumental Activities of Daily Living (IADL) scale. Arterial function was measured by ankle‐brachial index (ABI) and branchial‐ankle pulse‐wave velocity (baPWV). Physical function was assessed by the Short Physical Performance Battery (SPPB). Logistic regression and mediation model were used to analysis. Results: The mean age of the final analysis sample (n = 616) was 59.0 ± 12.0 years. Hemodialysis patients with MCI were more likely to have lower ABI (p < 0.001) and higher baPWV (p < 0.01). After adjusting for covariates, lower ABI (abnormal ≤0.9 and borderline 0.91–0.99) were positively associated with MCI (OR = 4.43, 95% CI = 1.89–10.39; OR = 4.83, 95% CI = 1.61–14.46). SPPB total score and its components standing balance, gait speed score were negatively associated with MCI. In the mediational model, gait speed played a mediating role (indirect effect ab = −0.21; 95% CI = −0.58 to −0.03) in the association of ABI (≤0.9) and MMSE, while standing balance and chair stands did not. Conclusions: Lower gait speed mediates a positive association between ABI and MCI in hemodialysis patients. Suitable interventions for physical performance, especially gait speed, may reduce the risk of MCI in hemodialysis patients. [ABSTRACT FROM AUTHOR]

purpose of this study is to observe the correlation between high sensitivity C-reactive protein (hs-CRP) and metabolic syndrome (MetS) in hemodialysis patients, determine its optimal cut-off point value, and compare the diagnostic ability of different inflammatory markers for MetS. Methods: This cross-sectional study finally included 860 long-term hemodialysis patients (male 524, average age 61.5 years) from seven dialysis centers in Shanghai, China. The International Diabetes Federation metabolic syndrome guidelines were used to define MetS, including high waist circumference, elevated blood pressure, elevated fasting blood glucose, elevated triglycerides, and reduced HDL cholesterol. Serum hs-CRP was determined by the immunonephelometric assay. The association with MetS was observed according to the quartile of inflammatory markers, and then the optimal cut-off point value of the hs-CRP was determined by ROC analysis. Results: The overall prevalence of MetS was 55.1% (46.6% in males and 68.5% in females). In the final logistic regression model, there was a significant, graded positive association between hs-CRP and MetS (p for trend = 0.010). The traditional inflammatory markers leukocytes, neutrophils, lymphocytes, monocytes and neutrophil-to-lymphocyte ratio (NLR) were not associated with MetS. The results of the ROC analysis showed that the optimal cut point value of hs-CRP for the diagnosis of MetS was 1.58 mg/L. In the components of MetS and hs-CRP was significantly positively associated with high waist circumference, elevated TG and low HDL (p < 0.05). Conclusion: The increase in hs-CRP concentration is significantly associated with the risk of MetS, and the diagnostic ability of hs-CRP for MetS is better than traditional inflammatory markers. [ABSTRACT FROM AUTHOR]