Physical activity, chronic kidney disease, and cardiovascular risk: A study in half a million adults

Abstract

Objective: There is a growing prevalence of chronic kidney disease (CKD), a con- dition associated with a higher cardiovascular disease (CVD) risk. We assessed the association between self-reported physical activity (PA) and CKD and also studied whether PA attenuates CKD-associated CVD risk. Methods: A cohort of Spanish adults (18–64 years) participated in this nation- wide study. Participants were categorized at baseline as being either inactive (per- forming no PA), regularly, or insufficiently active (meeting or not, respectively, international PA recommendations) and were followed for up to 5 years. The presence of CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2) and major CVD risk factors (diabetes, hypercholesterolemia, hypertension, obesity) was determined at baseline and at follow- up. Results: 517 917 participants (44 ± 9 years, 67% male, CKD prevalence = 7%) were studied at baseline, with prospective analyses (median follow-up = 2 years, range = 2–5) in a subcohort of 264 581 individuals. Compared to physical inactiv- ity, cross-sectional analyses at baseline showed that regular PA (odds ratio = 0.80; 95% confidence interval = 0.79–0.81), but not insufficient PA (1.02; 0.99–1.04) was associated with lower CKD prevalence. However, prospective analyses failed to confirm this association (p > 0.1). In turn, CKD was associated with a higher prev- alence of hypertension (+3%) and diabetes (+5%) at baseline and with a greater incidence of hypertension at follow-up (+37%). Among those participants with CKD, regular PA was associated with a lower prevalence (−45% to −7%) and in- cidence (−38% to −4%) of all CVD risk factors. Conclusion: Although PA might not reduce incident CKD in the middle term (~2 years), it can attenuate the CVD risk linked to this condition.