Moderate-to-vigorous Physical Activity and Sedentary Behavior Are Independently Associated With Renal Function: A Cross-sectional Study

Abstract

Background: Little is known about whether insufficient moderate-to-vigorous physical activity (MVPA) and longer sedentary behavior (SB) are independently associated with estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD), whether they interact with known risk factors for CKD, and the effect of replacing sedentary time with an equivalent duration of physical activity on kidney function.

Methods: We examined the cross-sectional association of MVPA and SB with eGFR and CKD in 66,603 Japanese cohort study in 14 areas from 2004 to 2013. MVPA and SB were estimated using a self-reported questionnaire, and CKD was defined as eGFR <60 mL/min/1.73 m². Multiple linear regression analyses, logistic regression analyses, and an isotemporal substitution model were applied.

Results: After adjusting for potential confounders, higher MVPA and longer SB were independently associated with higher eGFR (P for trend MVPA <0.0001) and lower eGFR (P for trend SB <0.0001), and a lower odds ratio (OR) of CKD (adjusted OR of MVPA ≥20 MET·h/day, 0.76; 95% confidence interval [CI], 0.68-0.85 compared to MVPA <5 MET·h/day) and a higher OR of CKD (adjusted OR of SB ≥16 h/day, 1.81; 95% CI, 1.52-2.15 compared to SB <7 h/day), respectively. The negative association between MVPA and CKD was stronger in men, and significant interactions between sex and MVPA were detected. Replacing 1 hour of SB with 1 hour of physical activity was associated with about 3 to 4% lower OR of CKD.

Conclusion: These findings indicate that replacing SB with physical activity may benefit kidney function, especially in men, adding to the possible evidence on CKD prevention.

Keywords: chronic kidney disease; glomerular filtration rate; isotemporal substitution model; physical activity; sedentary.

Figure 1.. Adjusted odd ratios (ORs) for chronic kidney disease (CKD) according to sedentary behavior (SB; h/day) by moderate-to-vigorous physical activity (MVPA; MET·h/day). Adjusted variables are age, study site, education level (≤12 years or >12 years), current smoking (yes or no), alcohol consumption (g/day), daily coffee consumption (yes or no), history of hypertension (yes or no), history of hyperlipidemia (yes or no), history of diabetes (yes or no), and body mass index (quartile). Error bars indicate 95% confidence interval. P for trends of adjusted OR for CKD among subjects with MVPA ≥10 and <10 were <0.001 and <0.002, respectively.

Figure 2.. Adjusted odd ratios (ORs) for chronic kidney disease (CKD) according to moderate-to-vigorous physical activity (MVPA; MET·h/day) by sex. Adjusted variables are age, study site, education level (≤12 years or >12 years), current smoking (yes or no), alcohol consumption (g/day), daily coffee consumption (yes or no), history of hypertension (yes or no), history of hyperlipidemia (yes or no), history of diabetes (yes or no), body mass index (quartile), and sedentary behavior (hours/day). Error bars indicate 95% confidence interval. P for trends of adjusted OR for CKD among men and women were 0.528 and 0.038, respectively.