Long-Term Physical Exercise for Preventing CKD in Older Adults: A Randomized Clinical Trial

Area of Science:

• Gerontology
• Nephrology
• Exercise Physiology

Background:

• Chronic kidney disease (CKD) is a significant global health concern.
• Physical exercise is known to benefit kidney health, but its specific effects on kidney function preservation in older adults require further investigation.
• Understanding the dose-response relationship between exercise and kidney function is crucial for public health recommendations.

Purpose of the Study:

• To investigate the dose-response effect of physical exercise on kidney function preservation in older adults.
• To compare the impact of moderate-intensity continuous training versus high-intensity interval training on the rate of estimated glomerular filtration rate (eGFR) decline.
• To analyze the association between changes in physical activity levels and the risk of rapid eGFR decline.

Main Methods:

• A post-hoc analysis of the 5-year Generation 100 Study, a randomized clinical trial involving older adults aged 70-77.
• Participants were assigned to a control group (information on physical activity recommendations), moderate-intensity continuous training, or high-intensity interval training.
• The primary outcome measured was rapid eGFR decline, defined as >5 mL/min/1.73 m² per year, using cystatin C.

Main Results:

• High-intensity interval training (HIIT) showed a significant reduction in rapid eGFR decline (23%) compared to the control group (30%).
• A significant dose-response relationship was observed, with HIIT demonstrating a relative risk of 0.75 (95% CI 0.59-0.95) for rapid eGFR decline compared to controls.
• Observational analyses indicated that increasing moderate-vigorous physical activity was associated with a lower risk of rapid eGFR decline (RR 0.73).

Conclusions:

• High-intensity interval training significantly reduces the risk of rapid estimated glomerular filtration rate decline in older adults.
• Physical exercise, particularly high-intensity interval training, plays a vital role in preserving kidney function in aging populations.
• The findings support the implementation of structured exercise programs to mitigate kidney function decline in older adults.