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

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/1.73m 2 ( 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 m 2 ) was larger than that in the daytime work group (−7.45 mL/min/1.73 m 2 ). The odds ratio for eGFR reduction to < 60 mL/min/1.73 m 2 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.