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Published on: June 16, 2014
Physical activity patterns and chronic kidney disease risk: a 5-year study in stage 1 cardiovascular-kidney-metabolic
Shiyue Wang1, Pingping Liu2, Tingting Li3
1School of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.
Insights
Maintaining consistent physical activity, particularly a high-level parabolic pattern (HPPA), significantly lowers chronic kidney disease (CKD) risk in stage 1 Cardiovascular-Kidney-Metabolic syndrome (CKM) patients.
Area of Science:
- Gerontology
- Nephrology
- Cardiology
- Metabolic Syndrome Research
Background:
- Cardiovascular-kidney-metabolic syndrome (CKM) and chronic kidney disease (CKD) share bidirectional links.
- Limited research exists on physical activity patterns and CKD risk in early-stage CKM patients.
Purpose of the Study:
- To investigate the association between physical activity patterns and CKD risk in middle-aged and older adults with stage 1 CKM.
- To identify specific physical activity levels and patterns that mitigate CKD progression.
Main Methods:
- Longitudinal analysis of China Health and Retirement Longitudinal Study (CHARLS) data (2015-2020).
- Latent Class Growth Model to identify physical activity patterns (e.g., high-level parabolic - HPPA, low-level decreasing - LCDPA).
- Restricted Cubic Spline and Generalized Linear Models to assess nonlinear associations between physical activity (MET) and CKD risk.
Main Results:
- 55% of participants progressed to CKD over 5 years.
- Two distinct physical activity patterns identified: HPPA (n=428) and LCDPA (n=2167).
- CKD risk significantly decreased with higher MET thresholds at baseline, 3, and 5 years; HPPA showed a significant reduction in CKD risk (OR=0.18) compared to LCDPA.
Conclusions:
- Physical activity exhibits a nonlinear association with CKD risk in stage 1 CKM.
- Achieving and maintaining specific MET thresholds is crucial for reducing CKD incidence.
- Promoting sustained higher physical activity, like HPPA, is a potential strategy for CKD prevention in this population.
Background:
Cardiovascular-kidney-metabolic syndrome (CKM) and chronic kidney disease (CKD) exhibit bidirectional associations. Limited research has explored the relationship between physical activity patterns and CKD risk among middle-aged and older adult participants with stage 1 CKM.
Methods:
This longitudinal analysis used China Health and Retirement Longitudinal Study (CHARLS) data from 2015, 2018, and 2020, including 2569 participants with stage 1 CKM. Physical activity was assessed using the International Physical Activity Questionnaire with Metabolic Equivalent of Task (MET) calculations. A Latent Class Growth Model was constructed to examine patterns in physical activity across follow-up points. Restricted Cubic Spline analysis examined nonlinear associations between MET and CKD risk, while a Generalized Linear Model evaluated associations between physical activity patterns and CKD incidence.
Results:
The CKM stage 1 participants' mean [SD] age was 59 years, 69% (1766/2569) were female, and 59% (1518/2569) had low educational attainment. During the 5-year follow-up, 55% (1415/2569) of participants progressed to CKD. Two physical activity patterns were identified: a high-level parabolic physical activity pattern (HPPA; n = 428) and a low-level continuously decreasing physical activity pattern (LCDPA; n = 2167). Significant nonlinear associations existed between physical activity levels and CKD risk. CKD risk was significantly reduced when weekly physical activity reached 2613 MET at baseline, 3066 MET at 3 years, and 5907 MET at 5 years (all P < 0.001). Compared with LCDPA, HPPA significantly reduced CKD risk (OR = 0.18; 95% CI, 0.13-0.24; P < 0.001), with consistent protective effects across all subgroups.
Conclusion:
Physical activity in stage 1 CKM participants is nonlinearly associated with CKD risk. Maintaining specific MET thresholds at diagnosis, 3 years, and 5 years post-diagnosis significantly reduced CKD incidence. HPPA significantly reduced CKD risk compared to LCDPA, and suggests that encouraging higher sustained physical activity could be valuable for CKD prevention in this population.
Data Registration:
This study used data from the China Health and Retirement Longitudinal Study (CHARLS), publicly available at http://charls.pku.edu.cn (registration required). The processed datasets and analysis code are openly available in the Zenodo repository: https://zenodo.org/records/17840857 (10.5281/zenodo.17840857).
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