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Updated: Jul 29, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
[Prospective association between physical activity and mortality in patients with chronic kidney disease]
1Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Insights
Engaging in physical activity significantly lowers the risk of death from all causes, cardiovascular disease (CVD), and chronic kidney disease (CKD) among CKD patients. This includes occupational, commuting, and household activities, as well as low and moderate-vigorous intensity exercises.
Area of Science:
- Nephrology
- Epidemiology
- Public Health
Context:
- Chronic kidney disease (CKD) affects a significant population, increasing mortality risk.
- Understanding modifiable lifestyle factors like physical activity is crucial for managing CKD outcomes.
- Previous research on physical activity and mortality in CKD patients, particularly in Chinese populations, is limited.
Purpose:
- To prospectively investigate the association between physical activity and mortality (all-cause, CVD, and CKD) in Chinese patients with CKD.
- To examine the impact of different types (total, occupational, commuting, household, leisure-time) and intensities (low, moderate-vigorous) of physical activity on mortality risk.
- To provide evidence-based recommendations for physical activity interventions in CKD management.
Summary:
- A study of 6,676 CKD patients in China followed for nearly 12 years found that higher levels of total physical activity were associated with reduced all-cause, CVD, and CKD mortality.
- Specific types of physical activity, including occupational, commuting, and household activities, showed significant inverse associations with mortality.
- Both low and moderate-vigorous intensity physical activities were linked to lower mortality risks, while leisure-time physical activity showed no significant association.
Impact:
- Physical activity emerges as a key protective factor against mortality in CKD patients.
- Findings support the integration of physical activity promotion into clinical practice for CKD management.
- This research contributes valuable data on physical activity and mortality in a large cohort of Chinese CKD patients, informing public health strategies.
Abstract:
Objective: To investigate the prospective association of physical activity with all-cause, cardiovascular disease (CVD), and chronic kidney disease (CKD) mortality in CKD patients in China. Methods: Cox proportional hazard models were used to evaluate the association of total, domain-specific, and intensity-specific physical activity with the risk of all-cause, CVD, and CKD mortality based on data from the baseline survey of China Kadoorie Biobank. Results: During a median follow-up of 11.99 (11.13, 13.03) years, there were 698 deaths in 6 676 CKD patients. Compared with the bottom tertile of total physical activity, participants in the top tertile had a lower risk of all-cause, CVD, and CKD mortality, with hazard ratios (HRs) (95%CIs) of 0.61 (0.47-0.80), 0.40 (0.25-0.65), and 0.25 (0.07-0.85), respectively. Occupational, commuting, and household physical activity were negatively associated with the risk of all-cause and CVD mortality to varying degrees. Participants in the top tertile of occupational physical activity had a lower risk of all-cause (HR=0.56, 95%CI: 0.38-0.82) and CVD (HR=0.39, 95%CI: 0.20-0.74) mortality, those in the top tertile of commuting physical activity had a lower risk of CVD mortality (HR=0.43, 95%CI: 0.22-0.84), and those in the top tertile of household physical activity had a lower risk of all-cause (HR=0.61, 95%CI: 0.45-0.82), CVD (HR=0.44, 95%CI: 0.26-0.76) and CKD (HR=0.03, 95%CI: 0.01-0.17) mortality, compared with the bottom tertile of corresponding physical activity. No association of leisure-time physical activity with mortality was observed. Both low and moderate-vigorous intensity physical activity were negatively associated with the risk of all-cause, CVD and CKD mortality. The corresponding HRs (95%CIs) were 0.64 (0.50-0.82), 0.42 (0.26-0.66) and 0.29 (0.10-0.83) in the top tertile of low intensity physical activity, and the corresponding HRs (95%CIs) were 0.63 (0.48-0.82), 0.39 (0.24-0.64) and 0.23 (0.07-0.73) in the top tertile of moderate-vigorous intensity physical activity. Conclusion: Physical activity can reduce the risk of all-cause, CVD, and CKD mortality in CKD patients.
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