Association between sleep quality and pre-hemodialysis blood pressure among patients undergoing hemodialysis: A cross-sectional study
https://doi.org/10.52235/lp.v7i3.798
Keywords:
sleep quality, blood tension, hemodialysis, chronic kidney diseaseAbstract
Background: Chronic kidney disease (CKD) is an ailment of kidney function that develops gradually and in advanced stages requires long-term hemodialysis therapy. Sleep disturbances are common among patients due to both physiological and psychological factors. Pourer sleep quality may elevate the sympathetic nervous system's responsiveness, disrupt fluid balance, and contribute to elevated blood pressure, particularly pre-hemodialysis blood pressure, which reflects the patient’s hemodynamic status prior to dialysis initiation.
Objective: This study aimed to assess the association between sleep quality and pre-hemodialysis blood pressure, including systolic and diastolic, in patients undergoing hemodialysis.
Methods: This research utilized a quantitative, cross-sectional methodology that was conducted in September 2025 at the Hemodialysis Unit of Universitas Muhammadiyah Malang Hospital, among 80 patients selected using purposive sampling, undergoing routine hemodialysis for at least three months at Universitas Muhammadiyah Malang Hospital, who were conscious and able to communicate verbally. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess quality of sleep, whereas pre-hemodialysis blood pressure including systolic and diastolic measurements was weighed prior to the dialysis procedure using a standard sphygmomanometer. Data were evaluated using the Spearman Rank test, with an established significance threshold of p <0.05.
Results: Of the total respondents, 42 (52.5%) had good sleep quality, while 38 (47.5%) experienced poor sleep quality. The median pre-hemodialysis blood pressure was 130/80 mmHg, indicating stage 1 hypertension. Statistical assessment disclosed a significant association between quality of sleep and pre-hemodialysis blood pressure category (p = 0.014) with a weak positive correlation (r = 0.274), revealing that poorer sleep quality was associated with higher blood pressure category, although the effect size was small.
Conclusion: Sleep quality is significantly associated with blood pressure in patients of pre-hemodialysis. Poorer sleep quality leads to be collaborated with higher blood pressure. However, the weak correlation (r = 0.274) suggests that sleep quality is one of several contributing factors to blood pressure variability in this population. These verdicts highlight the significance of assessing and managing sleep quality as part of comprehensive care in hemodialysis patients.
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Ademola, O., Id, A., Edeki, I. R., Oyedepo, D. S., Yisau, O. E., Ige, O. O., Ekrikpo, I. U., Id, S. M., Palencia, H., Noubiap, J. J., & Id, E. E. (2024). The prevalence and risk of mortality associated with intradialytic hypertension among patients with end-stage kidney disease on haemodialysis : A systematic review and. Plos One, 19(6). https://doi.org/10.1371/journal.pone.0304633
Al Ashari, M. R., & Muhdar, I. N. (2024). Faktor – Faktor Yang Mempengaruhi Tekanan Darah Tinggi Pada Usia 25 – 60 Tahun. Pontianak Nutrition Journal (PNJ), 7(1), 474. https://doi.org/10.30602/pnj.v7i1.1279
Alosaimi, F. D., Alshahrani, S. M., Aladhayani, M. H., & Alwethenani, Z. K. (2020). Psychosocial predictors of quality of life among chronic hemodialysis patients. Saudi Medical Jurnal, 41(9), 990–998. https://doi.org/10.15537/smj.2020.9.25271
Alshammari, B., Alkubati, S. A., Pasay-an, E., Alrasheeday, A., Alshammari, H. B., Asiri, S. M., Alshammari, S. B., Sayed, F., Madkhali, N., Laput, V., & Alshammari, F. (2023). Sleep Quality and Its Affecting Factors among Hemodialysis Patients: A Multicenter Cross-Sectional Study. Healthcare (Switzerland), 11(18). https://doi.org/10.3390/healthcare11182536
Andhika, R., Supriyadi, R., Bandiara, R., Sukesi, L., Sudarmadi, A. P., Wahyudi, K., & Sofiatin, Y. (2025). One-year Survival of End-Stage Kidney Disease Patients Undergoing Hemodialysis in Indonesia. International Journal of Nephrology and Renovascular Disease, 18, 87–101. https://doi.org/10.2147/IJNRD.S508012
Aneja, R. D., & Fatrida, D. (2026). Application of pursed-lip breathing to reduce fatigue in hemodialysis patients: A nursing case study. Lentera Perawat, 7(1), 27–36. https://doi.org/10.52235/lp.v7i1.630
Bucharles, S. G. E., Wallbach, K. K. S., de Moraes, T. P., & Pecoits-Filho, R. (2019). Hypertension in patients on dialysis: diagnosis, mechanisms, and management. Brazilian Journal of Nephrology, 41(3), 400–411. https://doi.org/10.1590/2175-8239-JBN-2018-0155
Bukhari, S. A. R. (2021). Sample Size Determination Using Krejcie and Morgan Table – Master In Educational Management & Leadership. February, 1–2. https://doi.org/10.13140/RG.2.2.11445.19687
Fatimah, L. F., & Endrat Kartiko Utomo, F. N. S. (2025). Hubungan Kepatuhan Pembatasan Cairan dan Lama Hemodialisis Dengan Kualitas Hidup Pasien Penyakit Ginjal Kronik. Jurnal Penelitian Profesional, 7(1), 143–150. https://doi.org/10.37287/jppp.v7i1.3912
GBD 2023 Kidney Failure with Replacement Therapy Collaborators. (2025). Articles Global , regional , and national prevalence of kidney failure with replacement therapy and associated aetiologies , 1990 – 2023 : a systematic analysis for the Global Burden of Disease Study 2023. The Lancet Global Health, 13, 1378–1395. https://doi.org/10.1016/S2214-109X(25)00198-6
Haliza, S. N., Lesmana, H., & Iskandar, A. C. (2026). Caregiver burden and coping strategies among family caregivers of patients with chronic kidney disease undergoing hemodialysis: A descriptive study. Lentera Perawat, 7(2), 420–429. https://doi.org/10.52235/lp.v7i2.749
Husna, R., Saida, S. A., & Cahyady, E. (2025). Hubungan Antara Kualitas Tidur Dengan Tekanan Darah Pada Pasien Hipertensi di Puskesmas Baiturrahman. The Journal of Multidisciplinary Research on Scientific and Advanced, 3(3), 1514–1521. https://doi.org/10.61579/future.v3i3.612
Johnson, H. M., Shimbo, D., Abdalla, M., Altieri, M. M., Bress, A. P., Carter, J., Commodore-Mensah, Y., Egan, B., Melnyk, B. M., Ogunniyi, M. O., Schott, S. L., Watson, K. E., Williamson, J. D., Jones, D. W., Ferdinand, K. C., Taler, S. J., Bansal, N., Bello, N. A., Cohen, J. B., … Whelton, P. K. (2025). 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee . In Hypertension (Dallas, Tex. : 1979) (Vol. 82, Issue 10). https://doi.org/10.1161/HYP.0000000000000249
Kurniawan, R., Ardi, N. B., & Setiawan, E. (2025). Hubungan Antara Interdialytic Weight Gain dengan Perubahan Tekanan Darah Intradialisis Pada Pasien Gagal Ginjal Kronik The Relationship Between Interdialytic Weight Gain and Intradialysis Blood Pressure Changes in Chronic Kidney Failure Patients. Salando Health Journal, 3(2), 66–73. https://doi.org/10.33860/shj.v3i2.4109
Kusumaningrum, W., Rosalina, R., & Setyoningrum, U. (2021). Hubungan Kualitas Tidur Dengan Tekanan Darah. Indonesian Journal of Nursing Research (IJNR), 3(2), 57. https://doi.org/10.35473/ijnr.v3i2.901
Mahdalena, & Hasibuan, T. D. (2023). Hubungan Kualitas Tidur Dengan Tekanan Darah Pada Pasien Hemodialisis Di Ruang Hemodialisa Rumah Sakit Aminah Tangerang. Indonesian Trust Health Journal, 6(2), 119–123. https://doi.org/10.37104/ithj.v6i2.190
Merdekawati, D., Dasuki, D., & Aguspairi, A. (2024). Validity of Blood Pressure Measurement in Hypertention Patients. Jurnal Ilmiah Ners Indonesia, 5(2), 101–109. https://doi.org/10.22437/jini.v5i2.36305
Putri, N. E., Nguyen, T. Van, Do, T., & Phong, T. (2024). The Correlation Between Quality of Sleep and Quality of Life in Hemodialysis Patients ; An Indonesian Sample. Journal South Eastern European Journal of Public Health, 25, 45–50. https://doi.org/10.70135/seejph.vi.1302
Rahman, Z., Putri, M. E., Sitindaon, S. H., & Kinanti, D. (2024). Perbedaan Tekanan Darah Sistolik Pasien Hemodialisa Komorbid Hipertensi dan Diabetes Melitus. Jurnal Ilmu Keperawatan (Journal of Nursing Sciences), 13(2), 233–240. https://doi.org/10.35328/keperawatan.v13i2.2834
Ramadhani, F., Ambarsarie, R., Anggraini, R., Ayu, D., & Dita, A. (2025). Sleep Quality and Faculty Performance : A Multivariate Analysis of Influencing Factors. Jurnal Kedokteran Dan Kesehatan, 25(1), 28–36. https://doi.org/10.18196/mmjkk.v25i1
Saraswati, N. L. G. I., Lestari, N. K. Y., & Putri, K. A. (2022). Hubungan Tingkat Stres Dengan Kualitas Tidur Pada Pasien Gagal Ginjal Kronik Yang Menjalani Hemodialisis. Malahayati Nursing Journal, 4(5), 1242–1249. https://doi.org/10.33024/mnj.v4i5.6598
Sari, I. K., Soelistyoningsih, D., Rifa’i, A., & Qodir, A. (2026). Association between family support and activities of daily living among patients undergoing hemodialysis: A cross-sectional study. Lentera Perawat, 7(2), 353–361. https://doi.org/10.52235/lp.v7i2.729
Savsar, A. (2025). Investigation of Sleep Quality and Intolerance of Uncertainty in Liver Transplant Recipients : A Cross- Sectional Study. 1–10. https://doi.org/10.1111/nhs.70029
Septimar, Z. M., & Nurmalahayati, D. R. (2019). Faktor-Faktor yang Mempengaruhi Hipotensi Intradialisis pada Pasien Gagal Ginjal Kronik yang Menjalani Hemodialisis. Jurnal Ilmu Kesehatan Masyarakat, 8(1), 1–5.
Subhaktiyasa, P. G. (2024). Menentukan Populasi dan Sampel : Pendekatan Metodologi Penelitian Kuantitatif dan Kualitatif. Jurnal Ilmiah Profesi Pendididkanan, 9(4), 2721–2731. https://doi.org/10.29303/jipp.v9i4.2657
Utomo, E. K., Rahmasari, I., Soleman, S. R., Dwi, K. H., & Patiwi, N. O. (2024). Tekanan darah sebelum dan sesudah menjalani terapi hemodialisa. Prosiding Seminar Informasi Kesehatan Nasional, 6(2), 1–23. https://doi.org/10.47701/sikenas.vi.3907
Widiyastuti, N. F., Syahruddin, F. I., & Wahyu, S. (2024). Hubungan Kualitas Tidur dengan Tekanan Darah pada Pasien Hipertensi di Rumah Sakit Ibnu Sina. UMI Medical Journal, 9(1), 41–47. https://doi.org/10.33096/umj.v9i1.271
Yu, W., Zhang, J., He, L., & Tang, S. (2026). Global prevalence of poor sleep quality in hemodialysis patients : a systematic review and meta-analysis. 13. https://doi.org/10.3389/fmed.2026.1770352
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Copyright (c) 2026 Robiatul Adawiyah, Dwi Soelistyoningsih, Achmad Rifai, Wira Daramatasia, Angernani Trias Wulandari
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