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Effect of night shift work on the reduction of glomerular filtration rate using data from Korea Medical Institute (2016-2020)

  • Beom Seok Ko (Department of Occupational and Environmental Medicine, Dankook University Hospital) ;
  • Sang Yop Shin (Korea Medical Institute) ;
  • Ji Eun Hong (Department of Occupational and Environmental Medicine, Dankook University Hospital) ;
  • Sungbeom Kim (Department of Occupational and Environmental Medicine, Dankook University Hospital) ;
  • Jihhyeon Yi (School of Medicine, CHA University) ;
  • Jeongbae Rhie (Department of Occupational and Environmental Medicine, Dankook University Hospital)
  • Received : 2023.02.23
  • Accepted : 2023.05.27
  • Published : 2023.12.31

Abstract

Background: Shift work increases the risk of chronic diseases, including metabolic diseases. However, studies on the relationship between shift work and renal function are limited. The aim of this study was to investigate the association between shift work and a decreased glomerular filtration rate (GFR). Methods: Data were evaluated for 1,324,930 workers who visited the Korean Medical Institute from January 1, 2016 to December 31, 2020 and underwent a health checkup. Daytime workers were randomly extracted at a ratio of 1:4 after matching for age and sex. In total, 18,190 workers aged over 40 years were included in the analyses; these included 3,638 shift workers and 14,552 daytime workers. Participants were categorized into the shift work group when they underwent a specific health checkup for night shift work or indicated that they were shift workers in the questionnaire. The odds ratio was calculated using a conditional logistic regression to investigate the relevance of shift work for changes in GFR. Results: 35 workers in the shift group and 54 in the daytime group exhibited an estimated GFR (eGFR) value of < 60 mL/min/1.73m2 (p < 0.01). The difference in eGFR values between two checkups differed significantly depending on the type of work (p < 0.01); the difference in the shift work group (-9.64 mL/min/1.73 m2) was larger than that in the daytime work group (-7.45 mL/min/1.73 m2). The odds ratio for eGFR reduction to < 60 mL/min/1.73 m2 in the shift group versus the daytime group was 4.07 (95% confidence interval: 2.54-6.52), which was statistically significant. Conclusions: The results of this study suggest that eGFR decreases by a significantly larger value in shift workers than in daytime workers; thus, shift work could be a contributing factor for chronic kidney disease (CKD). Further prospective studies are necessary to validate this finding and identify measures to prevent CKD in shift workers.

Keywords

Acknowledgement

This research was funded by Korean Medical Institute's public offering for research purposes.

References

  1. Ban TH, Kwon YE, Kim TH. Trends in Epidemiologic Characteristics of End-Stage Renal Disease from 2020 KORDS (Korean Renal Data System). Seoul, Korea: The Korean Society of Nephrology; 2020. 
  2. Jeon KY. Development of an Epidemiologic Study Model for Occupational Chronic Kidney Disease. Ulsan, Korea: Korea Occupational Safety and Health Agency; 2019. 
  3. Chin HJ, Kim SG. Chronic kidney disease in Korea. Korean J Med 2009;76(5):511-4. 
  4. Costa G. Shift work and occupational medicine: an overview. Occup Med (Lond) 2003;53(2):83-8. https://doi.org/10.1093/occmed/kqg045
  5. Dochi M, Suwazono Y, Sakata K, Okubo Y, Oishi M, Tanaka K, et al. Shift work is a risk factor for increased total cholesterol level: a 14-year prospective cohort study in 6886 male workers. Occup Environ Med 2009;66(9):592-7. https://doi.org/10.1136/oem.2008.042176
  6. Hermansson J, Hallqvist J, Karlsson B, Knutsson A, Gillander Gadin K. Shift work, parental cardiovascular disease and myocardial infarction in males. Occup Med (Lond) 2018;68(2):120-5. https://doi.org/10.1093/occmed/kqy008
  7. Charles LE, Gu JK, Fekedulegn D, Andrew ME, Violanti JM, Burchfiel CM. Association between shiftwork and glomerular filtration rate in police officers. J Occup Environ Med 2013;55(11):1323-8. https://doi.org/10.1097/JOM.0b013e3182a299c9
  8. Sasaki S, Yoshioka E, Saijo Y, Kita T, Tamakoshi A, Kishi R. Short sleep duration increases the risk of chronic kidney disease in shift workers. J Occup Environ Med 2014;56(12):1243-8. https://doi.org/10.1097/JOM.0000000000000322
  9. How to select random sample in Excel. https://www.ablebits.com/office-addins-blog/excel-random-selection-sample/. Updated 2023. Accessed April 11, 2023. 
  10. World Health Organization. The Asia-Pacific Perspective: Redefining Obesity and its Treatment. Sydney, Australia: Health Communication Australia; 2020. 
  11. Zhang S, Wang Y, Zhu Y, Li X, Song Y, Yuan J. Rotating night shift work, exposure to light at night, and glomerular filtration rate: baseline results from a Chinese occupational cohort. Int J Environ Res Public Health 2020;17(23):9035.
  12. Kang EK, Kang GH, Uhm JY, Choi YG, Kim SY, Chang SS, et al. Association between shift work and microalbuminuria: data from KNHANES(2012-2014). Ann Occup Environ Med 2017;29(1):37.
  13. Uhm JY, Kim HR, Kang GH, Choi YG, Park TH, Kim SY, et al. The association between shift work and chronic kidney disease in manual labor workers using data from the Korea National Health and Nutrition Examination Survey (KNHANES 2011-2014). Ann Occup Environ Med 2018;30(1):69.
  14. Martino TA, Oudit GY, Herzenberg AM, Tata N, Koletar MM, Kabir GM, et al. Circadian rhythm disorganization produces profound cardiovascular and renal disease in hamsters. Am J Physiol Regul Integr Comp Physiol 2008;294(5):R1675-83. https://doi.org/10.1152/ajpregu.00829.2007
  15. Mills JN, Stanbury SW. Intrinsic diurnal rhythm in urinary electrolyte output. J Physiol 1951;115(1):18p-19p.
  16. Moore-Ede MC, Herd JA. Renal electrolyte circadian rhythms: independence from feeding and activity patterns. Am J Physiol 1977;232(2):F128-35. https://doi.org/10.1152/ajprenal.1977.232.2.F128
  17. Park N, Cheon S, Son GH, Cho S, Kim K. Chronic circadian disturbance by a shortened light-dark cycle increases mortality. Neurobiol Aging 2012;33(6):1122.e11-22. https://doi.org/10.1016/j.neurobiolaging.2011.11.005
  18. Shim HS, Kim H, Lee J, Son GH, Cho S, Oh TH, et al. Rapid activation of CLOCK by Ca2+-dependent protein kinase C mediates resetting of the mammalian circadian clock. EMBO Rep 2007;8(4):366-71. https://doi.org/10.1038/sj.embor.7400920
  19. Balsalobre A, Damiola F, Schibler U. A serum shock induces circadian gene expression in mammalian tissue culture cells. Cell 1998;93(6):929-37. https://doi.org/10.1016/S0092-8674(00)81199-X
  20. Wehrens SM, Christou S, Isherwood C, Middleton B, Gibbs MA, Archer SN, et al. Meal timing regulates the human circadian system. Curr Biol 2017;27(12):1768-1775.e3. https://doi.org/10.1016/j.cub.2017.04.059
  21. McMullan CJ, Curhan GC, Forman JP. Association of short sleep duration and rapid decline in renal function. Kidney Int 2016;89(6):1324-30. https://doi.org/10.1016/j.kint.2015.12.048
  22. Koch BC, Nagtegaal JE, Kerkhof GA, ter Wee PM. Circadian sleep-wake rhythm disturbances in end-stage renal disease. Nat Rev Nephrol 2009;5(7):407-16. https://doi.org/10.1038/nrneph.2009.88
  23. Timio M, Venanzi S, Lolli S, Lippi G, Verdura C, Monarca C, et al. "Non-dipper" hypertensive patients and progressive renal insufficiency: a 3-year longitudinal study. Clin Nephrol 1995;43(6):382-7.
  24. Fu S, Sun Y, Luo L, Ye P. Relationship of arterial compliance and blood pressure with microalbuminuria and mildly decreased glomerular filtration rate: a Chinese community-based analysis. PLoS One 2014;9(6):e101013.
  25. Hashimoto J, Ito S. Central pulse pressure and aortic stiffness determine renal hemodynamics: pathophysiological implication for microalbuminuria in hypertension. Hypertension 2011;58(5):839-46. https://doi.org/10.1161/HYPERTENSIONAHA.111.177469
  26. Cherney DZ, Miller JA, Scholey JW, Nasrallah R, Hebert RL, Dekker MG, et al. Renal hyperfiltration is a determinant of endothelial function responses to cyclooxygenase 2 inhibition in type 1 diabetes. Diabetes Care 2010;33(6):1344-6. https://doi.org/10.2337/dc09-2340
  27. Roskoden FC, Kruger J, Vogt LJ, Gartner S, Hannich HJ, Steveling A, et al. Physical activity, energy expenditure, nutritional habits, quality of sleep and stress levels in shift-working health care personnel. PLoS One 2017;12(1):e0169983.
  28. DiBona GF. Nervous kidney. Interaction between renal sympathetic nerves and the renin-angiotensin system in the control of renal function. Hypertension 2000;36(6):1083-8. https://doi.org/10.1161/01.HYP.36.6.1083
  29. Ishigaki S, Ohashi N, Isobe S, Tsuji N, Iwakura T, Ono M, et al. Impaired endogenous nighttime melatonin secretion relates to intrarenal renin-angiotensin system activation and renal damage in patients with chronic kidney disease. Clin Exp Nephrol 2016;20(6):878-84. https://doi.org/10.1007/s10157-015-1224-x