Extended Sedentary Time Increases the Risk of All-Cause Death and New Cardiovascular Events in Patients With Diabetic Kidney Disease

Abstract

Background: Sedentary behavior may be an independent risk factor for cardiovascular events. This study aimed to clarify the effects of extended sedentary time in patients with diabetic kidney disease (DKD) on the risk of all-cause death and new events. Methods and Results:A prospective cohort study was performed over 39 months. The study included 173 patients with DKD who completed the International Physical Activity Questionnaire (IPAQ) (101 men; mean age, 71±11 years); 37 patients (21.4%) were diagnosed with cardiovascular disease (CVD). New events were defined as all-cause death, cerebral stroke, or CVD requiring hospitalization or commencing hemodialysis (HD). Data were analyzed using a multivariate Cox proportional hazard regression model with variables, including sedentary time. There were 34 cases of new events during the observation period, including 4 cases of stroke, 20 cases of CVD, 4 cases of HD implementation, and 6 cases of death. Hazard ratio (HR) calculations for the new event onset group identified sedentary time as a significant independent variable. The independent variable that was identified as a significant predictor of new events was the sedentary time (60 min/day; HR: 1.23, 95% CI: 1.05-1.45, P=0.012). Conclusions:Extended sedentary time increased the risk of new cardiovascular or renal events and/or all-cause death in patients with DKD.

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

“…23 In addition, among nondialysis patients with CKD, extended sedentary time was associated with risk of all-cause and CVD-related mortality. 24,25 These studies reported a linear association between sedentary time and mortality risk, which was questionable. A systematic review demonstrated a nonlinear association between total sitting time and all-cause mortality in general population, with a threshold identified at 3-4 hours per day of TV viewing, above which the risk was significantly increased.…”

Impact of Effectiveness of Physical Activity in a Virtual Environment on the Regulation of Sclerostin and Interleukin 6 Levels in Haemodialysis Patients

“…It is important to emphasize that, according to the literature review, there are no reports focusing directly on the analysis of physical activity using IPAQ in the context of VR utilization among haemodialysis patients. Studies conducted in haemodialysis patient groups used IPAQ only to determine the relationship between the level of physical activity and the occurrence of sarcopenia [28], cognitive abilities [29], depression [30], cardiovascular disorders [31], and to compare the short version of the IPAQ with accelerometer-based physical activity measurement in haemodialysis patients [32], as well as to assess the plasma levels of 25-hydroxyvitamin D compared to the level of physical activity [33].…”

Physical exercise in kidney disease: A commonly undervalued treatment modality

“…Living an inactive and sedentary life has been associated with worse cardiovascular outcomes and mortality in kidney disease patients both dependant on dialysis and those who are not, with ameliorations in outcomes in subjects being more active. 5,[42][43][44] Physical exercise has considerable effects on vascular function both at acute and chronic stages through various mechanisms. The beneficial effects of exercise on vascular health include improvement in serum lipid profile and blood pressure, nonetheless, it is not limited to such alterations.…”

“…Living an inactive and sedentary life has been associated with worse cardiovascular outcomes and mortality in kidney disease patients both dependant on dialysis and those who are not, with ameliorations in outcomes in subjects being more active 5,42–44 …”