Kidney Week

Abstract: SA-PO1067

Prognostic Influence of Physical Activity and Sedentary Behavior in Patients with CKD: The CKD-REIN Study

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

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

Authors

• Hamroun, Aghiles, Centre Hospitalier Universitaire de Lille, Lille, Hauts-de-France, France

Aghiles Hamroun

• Bentegeac, Raphael, Centre Hospitalier Universitaire de Lille, Lille, Hauts-de-France, France

Raphael Bentegeac, MD, MPH

• Alencar de Pinho, Natalia, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Natalia Alencar de Pinho, PhD

• Lange, Celine, Agence de la biomedecine, La Plaine Saint-Denis, France

Celine Lange, MS

• Frimat, Luc, Centre Hospitalier Regional Universitaire de Nancy, Nancy, Grand Est, France

Luc Frimat, MD, PhD

• Fouque, Denis, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes , France

Denis Fouque, MD, PhD

• Massy, Ziad, AURA Paris, Paris, Île-de-France, France

Ziad Massy, MD, PhD

• Stengel, Benedicte, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Benedicte Stengel, MD, PhD

• Omorou, Abdou, Centre Hospitalier Regional Universitaire de Nancy, Nancy, Grand Est, France

Abdou Omorou, MD, PhD

Background

Although the benefits of adapted physical activity (APA) programs have been demonstrated, including among the population with chronic kidney disease (CKD), there is currently limited data on daily physical activity (DPA) in real life among these patients.

Methods

All patients included in the CKD-REIN prospective cohort (CKD stage 2-5) who completed the Global Physical Activity Questionnaire (GPAQ) at baseline were analyzed. The medical and psychosocial determinants of DPA were studied using a multivariable Poisson regression model. The associations between DPA, sedentary behavior and the risks of kidney failure and all-cause mortality were estimated using cause-specific Cox models adjusted for age, sex, CKD characteristics, medical history, and lifestyle factors. The variables for DPA and sedentary behavior were modeled both continuously (using restricted cubic splines) and categorically, in accordance with recommendations.

Results

Within the 2528 patients included (65% male, median age 69 years, median GFR = 32.8 mL/min/1.73m²), 48%, 25%, and 27% had low (< 600 MET.min/week), moderate (600-1500), and high (≥ 1500) DPA, respectively, defined by the WHO guidelines. Female sex, advanced age, obesity, and depression were significantly associated with lower DPA. We observed a strong linear association between the level of DPA and the risk of mortality in the fully adjusted models. Conversely, this risk increased non-linearly with the duration of sedentary behaviour per day (Figure 1).
For instance, higher DPA was significantly associated with better survival (HR = 0.84 [0.66 to 1.07], HR = 0.63 [0.47 to 0.82] for moderate and high activity, respectively, compared to low activity, p for trend < 0.001), with no association with the risk of kidney failure. Conversely, sedentary behavior (> 9 hours/day) was independently associated with an increased risk of death (HR = 1.39 [1.17 to 1.66], p < 0.001).

Conclusion

Like APA, real-life DPA is associated with better survival among the population of patients with CKD, independantly of sedentary behavior.