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Sleep and quality of life in kidney transplant recipients with and without non-melanoma skin cancer: a comparative study

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Abstract

Non-melanoma skin cancer (NMSC) is prevalent in kidney transplant recipients (KTR), related to the immunosuppressive effects of anti-rejection therapy. Sleep disturbances can alter the immune system and enhance oxidative stress, which may increase the risk of carcinogenesis. This study aimed to analyze the quality of life and sleep in KTR with and without NMSC. Participants answered a set of questionnaires, the WHOQOL-bref, the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Berlin Questionnaire and self-reported chronotype. The total sample was distributed in the following groups: KTR with NMSC (n = 42), KTR without NMSC (n = 43) and healthy controls (n = 41). The mean scores of the questionnaires were not statistically significant, except for 3 domains of PSQI (sleep quality, sleep latency and daily consequences of poor sleep). The KTR with NMSC and control group presented worse sleep quality. Worse sleep latency and more daytime consequences were found in KTR groups. All groups had a numerical predominance of low-quality sleep (PSQI) and greater sleepiness (EES). Higher risk of obstructive sleep apnea was not observed and the evening-type chronotype was most frequent. In the WHOQOL, compromised physical domain was observed in KTR. Significant results were reached in few aspects of quality of life and sleep comparing KTR and controls. All groups presented excessive daytime sleepiness and low-sleep quality.

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Funding

Our studies are supported by the Associação Fundo de Incentivo à Pesquisa (AFIP). MLA receives Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) (#2020/13467-8) fellowships. JT receives CNPq fellowship. EMSX receives a CAPES postgraduate grant (Finance Code - 001). GML received FAPESP student scholarship. No sponsorship was received for the publication of this manuscript.

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Authors and Affiliations

  1. Postgraduate Program in Translational Medicine, Escola Paulista de Medicina, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil

    Ellen M. S. Xerfan

  2. Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil

    Gabriela M. Leandro

  3. Department of Psychobiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

    Gabriel N. Pires, Monica L. Andersen & Sergio Tufik

  4. Sleep Institute, São Paulo, Brazil

    Gabriel N. Pires, Monica L. Andersen & Sergio Tufik

  5. Department of Dermatology, Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

    Anamaria S. Facina & Jane Tomimori

Authors
  1. Ellen M. S. Xerfan
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  2. Gabriela M. Leandro
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  3. Gabriel N. Pires
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  4. Monica L. Andersen
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  5. Sergio Tufik
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  6. Anamaria S. Facina
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  7. Jane Tomimori
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Contributions

EMSX and GML contributed equally as first authors in writing the original draft. GML contributed with data collection and providing study materials. GNP contributed with data analysis, providing study materials and review of the draft. MLA, ST, ASF and JT contributed with intellectual content and major revision of this work.

Corresponding author

Correspondence to Monica L. Andersen.

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All authors declare no conflict of interest.

Ethical approval

IRB approval status: Reviewed and approved by UNIFESP IRB; approval #1.232.191 (CAAE: 46696315.6.0000.5505).

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Participants have provided written informed consent to the publication of their case details.

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Xerfan, E.M.S., Leandro, G.M., Pires, G.N. et al. Sleep and quality of life in kidney transplant recipients with and without non-melanoma skin cancer: a comparative study. Arch Dermatol Res 316, 52 (2024). https://doi.org/10.1007/s00403-023-02735-x

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  • DOI: https://doi.org/10.1007/s00403-023-02735-x

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