Physical Activity and Change in Estimated GFR among Persons with CKD

Abstract

Physical activity may counteract metabolic disturbances that promote the progression of CKD. To address this concept, we performed a longitudinal cohort study of 256 participants in the Seattle Kidney Study, a clinic-based study of CKD. Participants with an estimated GFR (eGFR) of 15-59 ml/min per 1.73 m 2 at baseline were eligible for the study. Physical activity was quantified using the Four-Week Physical Activity History Questionnaire. We used generalized estimating equations to test associations of physical activity with change in eGFR determined by longitudinal measurements of serum cystatin C. Mean baseline eGFR was 42 ml/min per 1.73 m 2 . During a median 3.7 years of follow-up, the mean change in eGFR cystatin C was 27.6% per year (interquartile range, 216.8%, 4.9% per year). Participants who reported .150 minutes of physical activity per week had the lowest rate of eGFR cystatin C loss (mean 26.2% per year compared with 29.6% per year among inactive participants). In adjusted analyses, each 60-minute increment in weekly physical activity duration associated with a 0.5% slower decline per year in eGFR (95% confidence interval, 0.02 to 0.98; P=0.04). Results were similar in sensitivity analyses restricted to participants without cardiovascular disease or diabetes, or to participants with moderate/high physical function. After adjustment for eGFR at the time of questionnaire completion, physical activity did not associate with the incidence of ESRD (n=34 events). In summary, higher physical activity levels associated with slower rates of eGFR loss in persons with established CKD.

Association between chronic kidney disease and physical activity level in patients with ischemic heart disease

“…In our data, the patients with higher frequency of attendance to our cardiac rehabilitation program experienced an improvement of renal function as previously reported [15]. A prospective cohort study demonstrated that increasing physical activity delayed the deterioration of renal function in patients with stage G3-G4 CKD [8]. Furthermore, recent study reported that an aerobic exercise program was safely performed by patients with IHD who have CKD and improved their eGFR [15].…”

“…Wannamethee et al also reported that maintaining a physically active lifestyle could decrease the risk of all-cause mortality in patients with IHD [17]. Although it was formerly believed that increasing physical activity worsened renal function in patients with CKD via reduced renal blood flow, recent studies have shown beneficial effects on not only exercise capacity [18,19] but also renal function [8,15]. In our data, the patients with higher frequency of attendance to our cardiac rehabilitation program experienced an improvement of renal function as previously reported [15].…”

“…Many patients with IHD, however, tend to have poor physical activity after hospital discharge [6]. Increased physical activity also provides a large variety of health benefits to chronic kidney disease (CKD) patients [7,8]. However, previous studies reported that the majority of CKD patients were physically inactive in their daily living [7,9,10].…”

The accumulation of healthy lifestyle behaviors prevents the incidence of chronic kidney disease (CKD) in middle-aged and older males

“…Recently, several studies have demonstrated that individual lifestyle behaviors relating to The data are expressed as the mean ± SD and the number of subjects exercise, physical activity and diet correlate with the renal function. Robinson-Cohen et al [32] observed that each 60-min increment in weekly physical activity was associated with a 0.5 % slower decline of the eGFR per year. Howden et al [33] reported that lifestyle modifications focusing on exercise training in patients with CKD produced improvements in the cardiorespiratory fitness, body composition and cardiac diastolic function.…”

Tubular Secretion in CKD

“…30,31 From 2004 to the present, the SKS has recruited 691 patients from nephrology clinics at the Veteran's Administration Puget Sound Health Care System, the Harborview Medical Center, and the University of Washington Medical Center (all in Seattle, WA). Patients were eligible for the SKS if they had any stage of CKD, were at least 18 years old, and were not receiving any form of RRT.…”