To the Editor: Dr Bliwise and colleagues1 speculate on the beneficial and protective effects
of sleep on the risk of mortality among patients receiving hemodialysis, but
temporal changes in renal function also may have played a key role in their
On the one hand, the renal system is organized according to a specific
temporal order that is oscillatory in nature. Most, if not all, renal functions
exhibit temporal changes; for example, glomerular filtration rate, urine production,
and renal excretion of solutes all significantly increase during daytime and
reach their minimum at night.2
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