Habitual physical activity, renal function and chronic kidney disease: a cohort study of nearly 200 000 adults

Abstract

BackgroundThere is limited information on the association between habitual physical activity (PA) and renal function.ObjectiveTo report the longitudinal association between self-reported habitual PA and measures of renal function in a large cohort in Taiwan.MethodsA total of 199 421 participants (aged ≥20 years) were selected from a Taiwan cohort between 1996 and 2014. All participants underwent at least two standardised medical examinations between 1996 and 2014. Self-administrated questionnaires were used to collect information on habitual PA. We used a generalised linear mixed model to investigate the associations between habitual PA and yearly change in estimated glomerular filtration rate (eGFR). The Cox proportional hazard regression model was used to investigate the associations between habitual PA and incident chronic kidney disease (CKD).ResultsParticipants had a median follow-up duration of 4.2 years (0.2–18.9). The yearly mean (±SD) decrease in eGFR in participants with baseline very low-PA, low-PA, moderate-PA and high-PA was 0.46±1.01, 0.36±0.97, 0.30±0.94 and 0.27±0.91 mL/min/1.73 m2, respectively. Relative to the participants with very low-PA, the coefficients of yearly eGFR change were −43.93 (95% CI −79.18 to −8.68), 35.20 (95% CI −2.56 to 72.96) and 53.56 (95% CI 10.42 to 96.70) µL/min/1.73 m2, respectively, for the participants with low-PA, moderate-PA and high-PA, after controlling for a wide range of covariates. Relative to the very low-PA participants, those who had low-PA, moderate-PA and high-habitual PA had HRs of 0.93 (95% CI 0.88 to 0.98), 0.94 (95% CI 0.89 to 0.99) and 0.91 (95% CI 0.85 to 0.96) to develop CKD, respectively, after controlling for the covariates.ConclusionsA higher level of habitual PA is associated with a smaller decrease in the level of eGFR and a lower risk of developing CKD.

Leisure-time, occupational, and commuting physical activity and the risk of chronic kidney disease in a working population: a prospective cohort study

“…The nding in this study of no signi cant association between leisure-time physical activity and incident CKD agrees with other studies in Australia [10] and the United States [11,28] For example, the AusDiab Study of 6,318 Australian adults showed that inactive (0 min/week) and insu ciently active (< 150 min/week) leisure were not associated with a higher risk of CKD onset compared to su ciently active (≥ 150 min/week) [10]. By contrast, a more recent Taiwanese cohort study among 190,074 adults [13] reported a signi cant, albeit modest, reduction in CKD incident associated with leisure-time physical activity; compared to workers with very low leisure-time physical activity, HRs for low, moderate, and high leisure-time physical activity were 0.93 (95%CI 0.88-0.98), 0.94 (95%CI 0.89-0.99), and 0.91 (95%CI 0.85-0.96), respectively. Given this small size of risk reduction and no clear dose-response relationship in the Taiwanese cohort, together with no association in other prospective studies, the epidemiological evidence has not supported a signi cant protective role of leisure-time physical activity against CKD.…”

“…Physical activity is another important factor known to reduce cardiovascular risk [6] and is hypothesized to be an important modi able risk factor in the development of CKD, either directly or indirectly through favorable effects on diabetes, hypertension, and obesity [7,8]. Although physical inactivity has been reported as a risk factor of CKD in several cross-sectional studies [9][10][11][12], evidence from prospective studies has been limited and inconsistent [10,11,13].…”

“…The Australian Diabetes, Obesity, and Lifestyle (AusDiab) Study and the Health, Aging, and Body Composition (Health ABC) study have demonstrated that physical activity was not associated with risk of incident CKD [10,11]. By contrast, in a Taiwan cohort, a higher level of habitual physical activity was found to be associated with a lower risk of developing CKD [13].…”

“…In addition to the inconsistency in the association between physical activity and CKD, several other issues have not been addressed. First, cohort studies have focused on leisure-time physical activity alone or total physical activity (i.e., a combination of leisure-time and occupational physical activity) [10,11,13], but there is no evidence for the association in relation to other domains of physical activity, such as occupational or commuting physical activity. For a considerable fraction of the general population, work constitutes the main setting for physical activity [14].…”

Constipation and the Quality of Life in Conservatively Treated Chronic Kidney Disease Patients: A Cross-sectional Study

“…Recent studies suggest a two-way relationship between constipation and CKD. On the one hand, the presence of constipation is independently associated with a higher risk of developing CKD and end-stage renal disease (ESRD); it is hypothesized that these relationships can be mediated by an altered gut microbiota and/or be a result of common cause such as lack of regular physical activity 11 - 13 . On the other hand, CKD since its moderate stage (i.e.…”