Severe Albuminuria Associated With Poor Sleep Quality in Elderly Obese Non-Diabetic Adults: Study

A new study published in the journal of BMC Nephrology found that greater severity of albuminuria was significantly linked to poor sleep quality in elderly obese individuals without diabetes. This research identified an exploratory albumin-to-creatinine ratio (ACR) threshold of >778 mg/gCr associated with impaired sleep, though further prospective validation is needed before clinical application. The findings suggest that sleep assessment may be valuable in the routine care of older adults with moderate-to-severe albuminuria.

The analytical cross-sectional study from Cairo University hospitals examined 160 obese individuals over the age of 60 who attended outpatient clinics. All participants had elevated ACR levels above 30 mg/gCr, which was a key indicator of kidney stress and damage. This research determined whether a specific ACR threshold could predict sleep disturbances in elderly patients without diabetes.

Poor sleep affected more than half of the participants, with a prevalence rate of 51%. The patients with ACR levels equal to or greater than 500 mg/gCr were 9- times more likely to experience poor sleep quality when compared to those with lower albuminuria levels. Women and individuals with class II obesity were also found to face significantly higher risks.

An exploratory ACR threshold of more than 778 mg/gCr as the strongest predictor of poor sleep quality. At this level, the test demonstrated 68.35% sensitivity and 71.05% specificity in distinguishing patients with sleep disturbances. The subgroup analyses showed varying thresholds across sex and obesity categories, with the highest predictive accuracy observed among women and patients with class II obesity.

The study also found that higher ACR levels were closely associated with several specific sleep problems, which included more severe insomnia symptoms, longer time needed to fall asleep, shorter sleep duration, reduced sleep efficiency, and more frequent nighttime disturbances. Poor overall sleep quality scores increased significantly alongside worsening albuminuria severity.

The Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index questionnaires was used to assess sleep health. Individual components of sleep quality were analyzed in relation to albuminuria severity. The study observed significant interactions between factors like ACR levels, female gender, and obesity class, which may intensify the relationship between kidney dysfunction and sleep impairment.

Overall, this study found that routine sleep assessments may become an important part of caring for obese older adults with moderate-to-severe albuminuria to detect complications linked to aging, obesity, and kidney disease.

Source:

Soliman, A. R., Mohammed, A., Rakha, N. K., Abdelgawad, E. M., Attia, A., & Ahmed, R. M. (2026). Albumin/creatinine ratio thresholds associated with poor sleep quality in elderly obese non-diabetic individuals: a cross-sectional study. BMC Nephrology, 27(1). https://doi.org/10.1186/s12882-026-04959-1