Association between physical activity and change in renal function in patients after acute myocardial infarction

Abstract

Background Combined renal dysfunction worsens the subsequent prognosis in patients after acute myocardial infarction (AMI). Therefore, establishing a therapeutic modality to maintain or improve renal function in AMI patients is necessary. This study aimed to elucidate the association between physical activity level and change in renal function in such patients. Design Prospective and observational study. Methods We enrolled 41 patients (35 men; average age, 67.5 ± 12.6 years) after AMI onset. Blood biochemistry, urinalysis, and physical function tests were conducted at discharge and 3 months after discharge. Renal function was evaluated based on cystatin C based-estimated glomerular filtration rate (eGFRcys). The number of steps was recorded for 3 months post-discharge. Generalized estimating equations (GEE) was used to test the association between physical activity level and within-patient changes in eGFRcys. Results Patients were stratified into low (n = 21; number of steps, 2335 ± 1219 steps/day) and high groups (n = 20; number of steps, 7102 ± 2365 steps/day). eGFRcys significantly increased from baseline to after 3 months in the high group (76.5 ± 13.8 to 83.2 ± 16.0 mL/min/1.73 m 2 , q = 0.004), whereas no significant change was observed in the low group (65.1 ± 15.9 to 62.2 ± 20.2 mL/min/1.73 m 2 , q = 0.125). Result of GEE adjusted for potential confounding variables showed a significant positive association between physical activity level and within-patient changes in eGFRcys (p = 0.003). Changes in eGFRcys was -2.9 mL/min/1.73 m 2 among low group versus +6.7 mL/min/1.73 m 2 among high group. Conclusions Physical activity level was positively associated with changes in renal function, demonstrating that high physical activity may suppress renal function decline in patients after AMI.

Outpatient Cardiac Rehabilitation Suppresses Deterioration of Renal Function in Patients ≥75 Years of Age With Heart Disease

“…The results for the OCR group were similar to those reported by Hama et al 10 In addition, in the CKD group verification, eGFRcys increased significantly in the OCR compared with non-OCR group among patients with G3 CKD, similar to previous studies. 7, 10 Takaya et al 7 demonstrated a favorable effect on renal function when patients with G3 CKD performed moderate intensity exercise (50-60% of HR reserve or Borg's score [12][13]. The present study consisted of similar exercise intensity and showed suppressed deterioration of renal function, indicating that "functional renal reserve capacity" may be reversibly improved in patients with G3 CKD.…”

“…Earlier studies reported an association between PA and changes in renal function. For example, Robinson-Cohen et al 13 suggested that increased PA was associated with a lower risk of rapid kidney function decline among older adults when using eGFRcys to evaluate renal function and a questionnaire to evaluate PA. Sato et al 12 concluded that high PA may suppress the decline in renal function in patients after acute myocardial infarction (AMI) using an accelerometer to evaluate PA and eGFRcys to evaluate renal function.…”

Various roles of renal rehabilitation including prevention and improvement of renal function, cardiovascular disease, flail and life prognosis

“…If patients with post-AMI can keep higher activity of exercise, they can suppress the decline in renal function. 22 Even in patients with cardiac and renal dysfunction, exercise therapy would be effective for improving renal and cardiac function. 22 Frail prevalence is high in CKD patients.…”

“…22 Even in patients with cardiac and renal dysfunction, exercise therapy would be effective for improving renal and cardiac function. 22 Frail prevalence is high in CKD patients. The development of frailty also involves insufficient nutritional intake, uremia, systemic inflammation, diabetes and cardiovascular comorbidities, insulin resistance, metabolic acidosis, and others.…”

Clinical efficacy and safety of percutaneous coronary intervention for acute myocardial infarction complicated with chronic renal insufficiency

“…However, many other factors may lead to damage to cardiac function and myocardial cells. [8] Clinically, there are many complications of chronic renal failure with MI. Additionally, they cover a wide range, and the main pathological mechanism is still unclear.…”