Abstract
BackgroundCombined renal dysfunction worsens the subsequent prognosis in patients after acute myocardial infarction (AMI). Therefore, establishing a therapeutic modality to maintain or improve renal function in AMI patients is necessary. This study aimed to elucidate the association between physical activity level and change in renal function in such patients.DesignProspective and observational study.MethodsWe enrolled 41 patients (35 men; average age, 67.5 ± 12.6 years) after AMI onset. Blood biochemistry, urinalysis, and physical function tests were conducted at discharge and 3 months after discharge. Renal function was evaluated based on cystatin C based-estimated glomerular filtration rate (eGFRcys). The number of steps was recorded for 3 months post-discharge. Generalized estimating equations (GEE) was used to test the association between physical activity level and within-patient changes in eGFRcys.ResultsPatients were stratified into low (n = 21; number of steps, 2335 ± 1219 steps/day) and high groups (n = 20; number of steps, 7102 ± 2365 steps/day). eGFRcys significantly increased from baseline to after 3 months in the high group (76.5 ± 13.8 to 83.2 ± 16.0 mL/min/1.73 m2, q = 0.004), whereas no significant change was observed in the low group (65.1 ± 15.9 to 62.2 ± 20.2 mL/min/1.73 m2, q = 0.125). Result of GEE adjusted for potential confounding variables showed a significant positive association between physical activity level and within-patient changes in eGFRcys (p = 0.003). Changes in eGFRcys was -2.9 mL/min/1.73 m2 among low group versus +6.7 mL/min/1.73 m2 among high group.ConclusionsPhysical activity level was positively associated with changes in renal function, demonstrating that high physical activity may suppress renal function decline in patients after AMI.
Highlights
Ischemic cardiac events, such as acute myocardial infarction (AMI), cause a decline in renal function [1]
Physical activity level was positively associated with changes in renal function, demonstrating that high physical activity may suppress renal function decline in patients after AMI
Most previous studies that examined the effect of exercise on renal function in AMI patients estimated renal function with serum creatinine, which depends on skeletal muscle mass [12]
Summary
Ischemic cardiac events, such as acute myocardial infarction (AMI), cause a decline in renal function [1]. Cardiac rehabilitation focusing mainly on supervised exercise therapy for AMI patients [7], or a group of patients with heart disease including those with AMI [8,9], was reported to be associated with maintaining and improving renal function. These reports suggest the possibility of kidney protection through exercise in AMI patients. The aim of this study was to elucidate the association between physical activity level and changes in renal function in patients after AMI using cystatin C. This study aimed to elucidate the association between physical activity level and change in renal function in such patients
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