Sedentary behavior as an emerging risk factor for chronic kidney disease: a narrative review

Sedentary behavior (SB) has gained attention as one of the behavioral risk factors, independent of physical inactivity. Patients with chronic diseases, such as hypertension and type 2 diabetes, tend to have longer SB, and prolonged SB is reported as a risk factor for adverse outcomes. Recently, these concerns have also been increasingly recognized in patients with chronic kidney disease (CKD). Despite growing interest, the role of SB in this population is still not well understood. This review aims to summarize the existing evidence on the association between SB and the risk of CKD. A total of 17 studies (9 cross-sectional and 8 longitudinal) were reviewed, indicating that longer SB is associated with an increasing risk of CKD. Through this review, we suggest that reducing SB may play a role in preventing the onset and slowing the progression of CKD. However, evidence remains limited, such as regarding the effective approaches to reduce SB in daily life among patients with CKD, and the causality between CKD and SB. Further high-quality studies, including randomized controlled trials, are warranted to explore these issues in this population.