Sedentary behavior and risk of chronic kidney disease: a systematic review and meta-analysis

Sedentary behavior has been considered a particular risk factor for adverse health outcomes independent of exercise, becoming a widespread public health issue globally. Many studies have analyzed the effect of sedentary behavior levels on the risk of chronic kidney disease (CKD), however, previous findings have been inconsistent. This study aims to evaluate the association between sedentary behavior and the risk of CKD.

Eleven databases were searched for relevant cohort studies that were published between September 2024 and the databases' inception. To assess the association between sedentary behavior and risk of CKD, we calculated pooled effect sizes as relative risk (RR) with 95% CI using a random effects model. Subgroup analysis, sensitivity analysis, and publication bias analysis were performed.

Eight cohort studies involving 996,489 participants were identified. There was significant heterogeneity in the study (I² = 58.0%, P = 0.02). Pooled results of the random effects model showed a positive correlation between sedentary behavior and the risk of CKD (RR = 1.15, 95% CI 1.08, 1.21). In addition, subgroup analysis revealed that the study area was a source of heterogeneity. Leisure-time sedentary behavior (RR = 1.26, 95% CI 1.16, 1.37) and combined sedentary behavior (RR = 1.16, 95% CI 1.08, 1.25) were positively related to risk of CKD. The result for occupational sedentary behavior (RR = 1.08, 95% CI 1.00, 1.16) suggested a borderline statistical significance.

Prolonged sedentary behavior, particularly during leisure time, is associated with an increased risk of CKD in adults, though residual confounding should be considered.