Association of Sedentary Lifestyle with All-Cause and Cause-Specific Mortality in Adults with Reduced Kidney Function

Abstract

Background: Individuals with chronic kidney disease tend to have sedentary behavior and decreased physical activity, both are independent predictors of mortality in general population. While physical inactivity correlates to adverse health outcomes in patients with reduced kidney function, it is unclear whether this relationship remains significant for sedentary behavior. Our study purpose is to evaluate the association of sedentary lifestyle with mortality risk in individuals with renal insufficiency. Methods: The study population were adult participants of 2007-2016 National Health and Nutrition Examination Survey (NHANES) with estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 or self-reporting receiving dialysis (N=1419). Sedentary lifestyle was defined as sedentary time > 6 hours per day. Outcome of interest was all-cause and cardiovascular disease (CVD)- or cancer-related mortality. Results: We observed that non-Hispanic Whites, and individuals with younger age and higher educational level were more likely to have sedentary lifestyle. During a median follow-up of 99 (interquartile range 70 to 128) months, a total of 458 participants died (3.98 deaths per 1000 person-months); 120 died from CVD and 92 from cancer, respectively. The crude analysis showed that individuals with sedentary lifestyle have higher risk of all-cause and CVD-related but not cancer-related mortality compared with the non-sedentary population. After adjusting for potential confounders, we showed that all-cause mortality and CVD-related mortality were 1.64-fold (95% CI 1.26-2.12) and 1.66-fold (95% CI 1.03-2.67) higher, respectively, in the sedentary population compared with the non-sedentary population. Similar results were observed in the sensitive analyses, in which we excluded individuals with dialysis, eGFR < 15 ml/min/1.73 m2, or mobility disability. Conclusions: Our findings suggest that sedentary lifestyle correlated to greater risk of all-cause and CVD-related mortality among individuals with reduced kidney function. Interventions targeting the individuals with risky behaviors may have practical importance for public health.

Relationship between Sociodemographic and Health-Related Factors and Sedentary Time in Middle-Aged and Older Adults in Taiwan

“…Participants reported their average sitting time during the past week, encompassing both weekdays and weekends. Subsequently, the average sitting time was then categorized as either <6 h per day or ≥6 h per day [ 27 , 39 ]. Physical activity was measured using the IPAQ-Computer Assessment Telephone Interview translated by Liou [ 38 ].…”