Trends in Adherence to Recommended Physical Activity and Its Association with Mortality and Disease Progression among US Adults with Chronic Kidney Disease

Qu, Xiaolin; Tong, Xin; Hou, Xi; Zhang, Junhui; Hou, Lijun; Chen, Jigang

doi:10.1159/000526956

Cited by 6 publications

(3 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In another study, the top priority for older CKD patients was maintaining independence through physical activity, whereas for younger patients, longevity and transplant candidacy were the most important motivating factors [ 38 ]. Evidence from cohort studies suggests that adherence to physical activity guidelines is significantly associated with all-cause mortality (HR: 0.49; 95% CI: 0.38–0.63), malignancy mortality (HR: 0.30; 95% CI: 0.17–0.52), and albumin-to-creatinine ratio (OR: -0.27; 95% CI: -0.39 to -0.15) [ 39 ]. A retrospective study showed that ‘non-completers’ (successful completion of a pragmatic renal rehabilitation program more than 50%) of renal rehabilitation had a 1.6-fold (95% CI 1.00-2.58) greater risk of a combined event [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Objectively measured daily steps as an outcome in a clinical trial of chronic kidney disease: a systematic review

Huang,

Wang,

Bai

et al. 2024

BMC Nephrol

View full text Add to dashboard Cite

Background Physical inactivity is prevalent among individuals with chronic kidney disease (CKD) and is linked to unfavorable outcomes. In recent years, daily steps have emerged as a prominent target for interventions in clinical trials. The present study endeavors to scrutinize the effectiveness and/or efficacy of various interventions on daily steps in patients with full-spectrum CKD. Methods In December 2022, a systematic search was conducted across three databases, namely PubMed, Embase, and Web of Science, and subsequently updated in June 2023. The inclusion criteria included randomized controlled studies, quasi-experimental studies, and single-arm trials that assessed an intervention’s impact on objectively measured daily steps in patients with chronic kidney disease. The Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool was used to assess the risk of bias in non-randomized controlled trials (RCT), while the Cochrane revised tool (ROB-2) was utilized for RCTs. Results Seventeen studies were deemed eligible for inclusion in this review, with a focus on examining the efficacy and/or effectiveness of exercise training-based interventions (n = 10), daily step goal-oriented interventions (n = 4), mobile health (mHealth) interventions (n = 1), different dialysis modalities (n = 1), and a “Sit Less, Interact, Move More” intervention (n = 1). The studies exhibit variability in their characteristics and assessment tools, reflecting the findings’ heterogeneity. The results indicate that increasing physical activity levels remain challenging, as only a limited number of studies demonstrated significant improvements in participants’ daily step counts from baseline to endpoint. Conclusion Clinical trials with daily steps as an outcome are still lacking in the CKD population. Well-designed clinical trials that objectively assess the physical activity of CKD patients are needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Objectively measured daily steps as an outcome in a clinical trial of chronic kidney disease: a systematic review

Huang,

Wang,

Bai

et al. 2024

BMC Nephrol

View full text Add to dashboard Cite

show abstract

“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Chuang,

Wang,

Huang

et al. 2023

Kidney360

View full text Add to dashboard Cite

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.

show abstract

“…A recent study examined the association between adherence to physical activity guidelines for aerobic activity and sedentary time, and their effects on mortality and disease progression among US adults with CKD. It found that increased aerobic activity and reduced sedentary time were associated with decreased mortality and prevention of disease progression (8). Additionally, resistance exercise training has been shown to increase muscle size and strength.…”

Section: Introductionmentioning

confidence: 99%

PAG Masked Protective Physical Exercise-Induced High H2S Levels in 5/6 Nephrectomized Rats

Seifi,

Kadkhodaei,

Bakhshi

et al. 2024

Iran J Pharm Res

View full text Add to dashboard Cite

Background: To investigate the mechanisms of exercise therapeutics in preclinical animal models of chronic kidney disease (CKD), PAG (D, L-propargylglycine), an inhibitor of hydrogen sulfide production, was used to examine the protective effects of physical activity on oxidative stress and inflammation levels during CKD. Methods: Male Wistar rats with CKD, induced by the 5/6 nephrectomy procedure and subjected to 8 weeks of exercise training, received injections of PAG, a cystathionine γ-lyase (CSE) inhibitor, at a dose of 19 mg/kg, i.p., twice a week during those 8 weeks. The systolic blood pressure (BP) and renal sympathetic nerve activity (RSNA) were assessed. Additionally, plasma creatinine, BUN, renal hydrogen sulfide (H2S) levels, oxidative stress, and inflammatory markers were evaluated. Results: In the PAG group, inhibition of H2S production significantly reversed the improvements in plasma creatinine, BUN, renal malondialdehyde (MDA) level, superoxide dismutase (SOD) activity, TNF-α, and IL-6 that were achieved by exercise. Additionally, high RSNA and high BP, which were also reversed in the PAG group, compared to the CKD group subjected to exercise training. Conclusions: The results suggest that the improvement in BP, oxidative stress, and inflammation status by exercise in CKD may be at least partially due to CSE/H2S signaling.

show abstract

Trends in Adherence to Recommended Physical Activity and Its Association with Mortality and Disease Progression among US Adults with Chronic Kidney Disease

Cited by 6 publications

References 37 publications

Objectively measured daily steps as an outcome in a clinical trial of chronic kidney disease: a systematic review

Objectively measured daily steps as an outcome in a clinical trial of chronic kidney disease: a systematic review

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

PAG Masked Protective Physical Exercise-Induced High H2S Levels in 5/6 Nephrectomized Rats

Contact Info

Product

Resources

About