More physical activity may reduce mortality in CKD by 50%
Higher physical activity levels were associated with a 52% lower mortality rate vs. lower levels of activity, according to a study that assessed the link between activity and health outcomes for patients with chronic kidney disease.
“Physical activity level has been shown to be a potentially modifiable risk factor for adverse outcomes in a number of populations, including individuals on [hemodialysis] HD and those with mild to moderate CKD,” Christie Rampersad, MD, of the University of Manitoba, Winnipeg, Canada, and colleagues wrote. “However, there is a paucity of studies examining this association in patients with advanced CKD who are not receiving renal replacement therapy (RRT). The Canadian Frailty Observation and Interventions Trial (CanFIT) study is a longitudinal observational multicenter study which measures multiple domains of frailty in this population. As part of study visits, patients self-reported their physical activity using the physical activity scale for the elderly (PASE), which is a well-validated questionnaire that includes activities commonly performed by older adults.”
In total, researchers recruited 579 patients with CKD stages G4 to G5 (defined as eGFR less than 30 mL/min/1.73m2) and considered all-cause mortality, progression to kidney failure and falls. Specific activities that comprised the physical activity score included occupational, household and leisure activities, as well as muscle strengthening and sports and recreation. Adjustments were made for age, sex and comorbidity.
Patients were followed for 1,193 days, during which 118 patients died, 204 progressed to dialysis and 129 reported a fall.
While researchers observed no associations between higher levels of physical activity and either slower progression to kidney failure or a lower rate of future falls, they determined higher levels of physical activity were associated with a 52% lower all-cause mortality (adjusted HR = 0.48).
Rampersad and colleagues acknowledged a variety of limitations to the study, including the lack of diversity within the cohort, which was predominately made up of white patients.
“As such, these findings should be replicated in other settings with a higher proportion of individuals of Hispanic, African and Indigenous descent,” the researchers wrote. “Furthermore, we were unable to adjust for smoking, BMI and proteinuria, which have been shown to be independently associated with mortality in patients with advanced CKD. Finally, it is important to note that these findings are observational in nature, and interventional studies targeting physical activity behavior in the CKD population are needed to confirm whether physical activity is truly a causal and modifiable risk factor for mortality.”