Correlation Between Preoperative Sleep and Postoperative Brain and Renal Dysfunction

Correlation Between Preoperative Sleep Parameters Clustering and Postoperative Brain and Renal Dysfunction

To explore the correlation between preoperative sleep parameter clustering and postoperative brain and renal dysfunction.

Study Overview

• Status: Not yet recruiting
• Conditions: Postoperative Delirium; Acute Kidney Injury

Detailed Description

Postoperative delirium (POD) and acute kidney injury (AKI) are common and serious complications following cardiac surgery. They often occur concurrently and interact with each other, significantly prolonging hospital stay, increasing medical costs, and correlating with long-term cognitive decline, renal function deterioration, and elevated mortality risk. The recently proposed brain-kidney axis theory suggests that the central nervous system and the kidney communicate bidirectionally through pathways including inflammation, oxidative stress, sympathetic overactivation, and hemodynamic instability, amplifying damage in a cascade manner. This provides an important theoretical framework for understanding the comorbidity mechanism of postoperative delirium and renal injury. Early identification of modifiable preoperative risk factors and blocking abnormal activation of the brain-kidney axis are critical to improving outcomes in cardiac surgery patients.

A growing body of evidence indicates that preoperative sleep disturbance is highly prevalent in surgical patients and represents an independent risk factor for adverse perioperative outcomes. Sleep disruption can disrupt circadian rhythms, exacerbate systemic inflammation, impair neurocognitive function, disturb renal hemodynamic homeostasis, and simultaneously aggravate secondary damage to both the central nervous system and the kidney via the brain-kidney axis, thereby significantly increasing the risk of comorbid postoperative delirium and acute kidney injury. However, most previous studies evaluated sleep using a single total scale score or one-dimensional indicators, which cannot fully capture the complexity and heterogeneity of preoperative sleep architecture.

To date, few studies have explored the associations between preoperative sleep phenotypes and postoperative POD, AKI, or their comorbidity in cardiac surgery based on objective sleep monitoring data and combined with the brain-kidney axis theory. Furthermore, the potential mediating role of postoperative sleep disturbance in these pathways remains unclear.

Therefore, this study aims to identify preoperative sleep phenotypes in cardiac surgery patients using cardiopulmonary coupling-derived objective sleep parameters; to investigate the associations of different sleep phenotypes with postoperative POD, AKI, and their comorbidity; and to further conduct subgroup analyses and mediation analyses to explore effect modifiers and underlying mechanisms, with a particular focus on the pathways through which abnormal sleep affects adverse postoperative outcomes via the brain-kidney axis.

• Study Type: Observational
• Enrollment (Estimated): 549

Contacts and Locations

• Study Contact: Name: Chong Lei; Phone Number: 18629011362; Email: crystalleichong@126.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Adults scheduled for elective cardiac surgery with cardiopulmonary bypass

Description

Inclusion Criteria:

Aged 18 years or above who were scheduled for elective cardiac surgery with cardiopulmonary bypass

Exclusion Criteria:

Patients undergoing congenital heart disease repair surgery or surgeries necessitating deep hypothermic circulatory arrest were excluded.

Patients with a history of schizophrenia, epilepsy, Parkinson's disease, myasthenia gravis, or neurosurgery were also excluded.

Patients with a preoperative Mini - Mental State Examination (MMSE) score less than 24 , or those unable to communicate due to coma, severe dementia, or language barriers were excluded.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Preoperative sleep group; The patient underwent cardiopulmonary coupling sleep monitoring one night before operation

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative delirium	assessed with 3-minute confusion assessment method (3D-CAM) or confusion assessment method for the ICU (CAM- ICU）	within 1 week after operation
Acute kidney injury	assessed with KDIGO criterion	within 1 week after operation
Postoperative delirium combined with acute kidney injury	both diagnosed as postoperative delirium and acute kidney injury	within 1 week after operation

Collaborators and Investigators

• Sponsor: Xijing Hospital
• Investigators: Study Chair: Hailong Dong, Xijing Hospital

Study record dates

Study Major Dates

• Study Start (Estimated): April 10, 2026
• Primary Completion (Estimated): April 15, 2026
• Study Completion (Estimated): April 15, 2026

Study Registration Dates

• First Submitted: April 1, 2026
• First Submitted That Met QC Criteria: April 8, 2026
• First Posted (Actual): April 9, 2026

Study Record Updates

• Last Update Posted (Actual): April 9, 2026
• Last Update Submitted That Met QC Criteria: April 8, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Neurologic Manifestations; Nervous System Diseases; Mental Disorders; Postoperative Complications; Pathologic Processes; Male Urogenital Diseases; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Confusion; Neurobehavioral Manifestations; Neurocognitive Disorders; Renal Insufficiency; Delirium; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Emergence Delirium; Acute Kidney Injury
• Other Study ID Numbers: KY20222231

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No