Physical Activity and Rapid Decline in Kidney Function Among Older Adults

Department of Epidemiology, University of Washington, Seattle, 98195, USA.
Archives of internal medicine (Impact Factor: 17.33). 12/2009; 169(22):2116-23. DOI: 10.1001/archinternmed.2009.438
Source: PubMed


Habitual physical activity (PA) has both physiologic and metabolic effects that may moderate the risk of kidney function decline. We tested the hypothesis that higher levels of PA are associated with a lower risk of kidney function decline using longitudinal data from a large cohort of older adults.
We studied 4011 ambulatory participants aged 65 or older from the Cardiovascular Health Study (CHS) who completed at least 2 measurements of kidney function over 7 years. We calculated a PA score (range, 2-8) by summing kilocalories expended per week (ordinal score of 1-5 from quintiles of kilocalories per week) and walking pace (ordinal score for categories of <2, 2-3, and >3 mph). Rapid decline in kidney function decline (RDKF) was defined by loss of more than 3.0 mL/min/1.73 m(2) per year in glomerular filtration rate, which we estimated by using longitudinal measurements of cystatin C levels.
A total of 958 participants had RDKF (23.9%; 4.1 events per 100 person-years). The estimated risk of RDKF was 16% in the highest PA group (score of 8) and 30% in the lowest PA group (score of 2). After multivariate adjustment, we found that the 2 highest PA groups (scores of 7-8) were associated with a 28% lower risk of RDKF (95% confidence interval, 21%-41% lower risk) than the 2 lowest PA groups (score of 2-3). Greater kilocalories of leisure-time PA and walking pace were also each associated with a lower incidence of RDKF.
Higher levels of PA are associated with a lower risk of RDKF among older adults.

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Available from: Cassianne Robinson-Cohen, Jan 15, 2014
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    • "A recent Cochrane review has highlighted the potential positive effects of regular leisure exercise on advanced CKD mainly through the improvement of cardiovascular risk (diabetes, high blood pressure) [11] [12] [13] [14] and aerobic capacity [11]. However, the effect of physical activity on early stages of CKD is not well-established [12], and few studies have focused specifically on it [15] [16] [17]. The eGFR is one of the essential determinants that characterize CKD. "
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    International Journal of Cardiology 09/2014; 177(3):1036-1041. DOI:10.1016/j.ijcard.2014.09.102 · 4.04 Impact Factor
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    • "In the present study daily physical activity was positively correlated with creatinine clearance. Indeed, previous studies have shown that habitual physical activity was positively associated with renal function [31–33]. Why decrease in creatinine clearance was associated with decreased physical activity? "
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    International Journal of Nephrology 12/2013; 2013:248416. DOI:10.1155/2013/248416
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    • "Medication inventories were completed by CHS staff using participants’ prescription and nonprescription medication bottles (24). Total physical activity was quantified in kilocalories per week using validated questionnaires assessing a broad range of common activities (30). BMI was calculated as weight (kg) divided by height (m2). "
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