Abstract

Abstract Background and Aims For patients with chronic kidney disease (CKD), evidence on the optimal dose of physical activity and possible harm with excessive exercise is limited. We aimed to analyze the dose-response association between leisure-time physical activity (LTPA) and mortality among participants with CKD and explore the optimal dose or possible harm associated with increased levels of physical activity. Method Leisure-time physical activity was self-reported. Data from 4604 adults with chronic kidney disease and without missing data for LTPA and mortality in the National Health and Nutrition Examination Surveys 1999-2012 were analyzed in 2019. Mortality was from baseline until 31 December 2015 Results During the median follow-up of 114 months, 1449 (31%) all-cause deaths were recorded. Comparing with inactive groups, the multi-variable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of 10-59, 60-149, 150-299, and 300-599 minutes/week of leisure-time physical activity for all-cause mortality were 0.71 (0.55-0.92), 0.78 (0.62-0.98), 0.79 (0.63-0.98), and 0.75 (0.57-0.99), respectively. The benefit appeared to reach a threshold of a 41% (HR,0.59; 95% CI, 0.41-0.84) lower risk of all-cause mortality among individuals reporting 600-1499 min/week for LTPA. And at ≥ 1500 min/week LTPA level, the HR and 95%CI were 0.66 (0.40-1.10). Conclusion LTPA was associated with reduced all-cause mortality in participants with CKD. We observed the optimal dose at the moderate-intensity LTPA level of approximately 600-1499 min/week and no longevity benefit at ≥1500 min/week.

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