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Kidney Week

Abstract: FR-PO1082

Relationships between Physical Activity, Vessel Health, and Kidney Function in CKD: An Observational Study

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Davies, Mark, NHS Wales Cardiff and Vale University Health Board, Cardiff, United Kingdom
  • Sandoo, Aamer, Institute for Applied Human Physiology, Bangor University, Bangor, United Kingdom
  • Alejmi, Abdulfattah, NHS Wales Betsi Cadwaladr University Health Board, Bangor, United Kingdom
  • Macdonald, Jamie Hugo, Institute for Applied Human Physiology, Bangor University, Bangor, United Kingdom
Background

The aims of this prospective, observational study were to determine if i) physical activity and kidney function were independently associated with markers of vessel health in patients with mild-moderate CKD; and ii) physical activity and vessel health exacerbate kidney function decline.

Methods

People with CKD stages 1 to 4 and healthy controls had baseline measurements of physical activity (by accelerometer), vessel health (micro-vessel and large artery endothelial-dependent (EDD) and independent (EID) dilation, and carotid intima-media thickness (cIMT)) and kidney function (estimated glomerular filtration rate (eGFR)). During a longitudinal follow-up period, the rate of decline in eGFR was measured. Multiple linear regression was used: i) in a cross-sectional analysis, to determine if vessel health, in additional to clinical variables (age, blood pressure, insulin resistance) was associated with physical activity or kidney function; and ii) in a longitudinal analysis, to determine if physical activity and vessel health (specifically, micro-vessel EDD), in additional to clinical variables, exacerbated kidney function decline.

Results

Answering aim i), 71 people with CKD and 12 controls were recruited and provided baseline data. Physical activity was independently associated with both large artery (ß=0.32;p=0.03) and micro-vessel EDD (ß=0.26;p<0.01) and cIMT (ß=-0.2;p=0.01). In contrast, kidney function was only independently associated with cIMT (ß=-0.25;p=0.01). Answering aim ii) 60 people with CKD were followed up for median (IQR) 20 (16 to 29) months. Neither micro-vessel EDD (ß=-0.07;p=0.20) nor physical activity (ß=0.04;p=0.69 independently predicted eGFR decline but exploratory analyses suggested large vessel EDD may predict eGFR decline (ß=0.12;p=0.07).

Conclusion

In the first study to combine objectively measured physical activity, vessel health and kidney function in people living with CKD, physical activity was independently associated with vessel function (micro and large vessel EDD), whilst physical activity and kidney function were independently associated with atherosclerosis (cIMT). These findings have implications for CKD cardiovascular risk management. Future research should confirm whether physical activity, via improvements in vessel health, can attenuate kidney function decline.

Funding

  • Private Foundation Support