Abstract
BackgroundFew studies examined the individual and conjoint associations of accelerometer-measured physical activity (PA) and sedentary times with the prevalence of chronic kidney disease (CKD) among older adults.MethodsWe evaluated 1,268 Framingham Offspring Study participants (mean age 69.2 years, 53.8% women) between 2011 and 2014. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.732 and/or urine albumin-to-creatinine ratio (UACR) ≥25/35 μg/mg (men/women). We used multivariable logistic regression models to relate time spent being sedentary and active with the odds of CKD. We then performed compositional data analysis to estimate the change in the eGFR and UACR when a fixed proportion of time in one activity behavior (among the following: moderate to vigorous physical activity [MVPA], light intensity physical activity [LIPA], and sedentary) is reallocated to another activity behavior.ResultsOverall, 258 participants had prevalent CKD (20.4%; 120 women). Higher total PA ([MVPA+LIPA], adjusted-odds ratio [OR] per 30 minutes/day increase, 0.86; 95% CI, 0.78–0.96) and higher LIPA (OR per 30 minutes/day increase, 0.87; 95% CI, 0.76–0.99) were associated with lower odds of CKD. Additionally, higher sedentary time (OR per 30 minutes/day increase, 1.16; 95% CI, 1.04–1.29) was associated with higher odds of CKD. Reallocating 5% of the time from LIPA to sedentary was associated with the largest predicted difference in eGFR (-1.06 ml/min/1.73m2). Reallocating 1% of time spent in MVPA to sedentary status predicted the largest difference in UACR (14.37 μg/mg).ConclusionThe findings suggest that increasing LIPA and maintaining MVPA at the expense of sedentary time may be associated with a lower risk of CKD in community-based older adults.
Highlights
The prevalence of chronic kidney disease (CKD) is approximately 13% in the U.S general population [1] and the number of patients with kidney failure treated by dialysis and transplantation has sharply increased during the past two decades [2]
Higher total physical activity (PA) ([moderate to vigorous PA (MVPA) +light-intensity PA (LIPA)], adjusted-odds ratio [odds ratios (OR)] per 30 minutes/day increase, 0.86; 95% confidence intervals (CI), 0.78–0.96) and higher LIPA (OR per 30 minutes/day increase, 0.87; 95% CI, 0.76–0.99) were associated with lower odds of CKD
The findings suggest that increasing LIPA and maintaining MVPA at the expense of sedentary time may be associated with a lower risk of CKD in community-based older adults
Summary
The prevalence of chronic kidney disease (CKD) is approximately 13% in the U.S general population [1] and the number of patients with kidney failure treated by dialysis and transplantation has sharply increased during the past two decades [2]. Evidence consistently suggests that higher physical activity (PA) is associated with lower odds of CKD. Cross-sectional studies have reported that higher levels of light-intensity PA (LIPA) [8, 9], moderate to vigorous PA (MVPA) [9,10,11,12,13], and total PA (MVPA+LIPA) [8, 14] were associated with lower odds of CKD. Cross-sectional studies have reported that higher levels of sedentary time are associated with higher odds of CKD in middle-aged [13, 14] and older adults [15]. Few studies examined the individual and conjoint associations of accelerometer-measured physical activity (PA) and sedentary times with the prevalence of chronic kidney disease (CKD) among older adults
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