medwireNews: Exercising at moderate-to-vigorous intensity on a regular basis is associated with a lower risk for developing chronic kidney disease (CKD) in people with type 2 diabetes and overweight or obesity, a post-hoc analysis of US study data suggests.
Over a median follow-up of 12 years, for every 100 minutes of moderate-to-vigorous physical activity performed across the week the overall risk for CKD was reduced by a significant 9%.
The risk reduction was greater, at a significant 19% per 100 minutes, if the exercise was performed in bouts of 10 minutes or more during the week, but regularly exercising in shorter bouts of 1–9 minutes was still associated with an 8% reduced risk for CKD, just not significantly so.
“Our study suggests that regardless of the length of [physical activity], being physically active is one of the cornerstones to preventing renal disease in [type 2 diabetes],” say Xianhui Qin (Southern Medical University, Guangzhou, China) and co-authors in the British Journal of Sports Medicine.
They add that the study “has important public health implications,” particularly for individuals who may be unwilling or unable to engage in physical activity that lasts for longer than 10 minutes at a time, as they could still benefit from the effects of moderate-to-vigorous physical activity taken in shorter spurts on a regular basis.
For their analysis, Qin and colleagues used data from the accelerometry substudy and the Movement and Memory ancillary study of the Look AHEAD trial, which had compared the effects of lifestyle intervention versus education in people with type 2 diabetes with overweight or obesity.
Participants’ physical activity was measured objectively in these studies using a triaxial accelerometer worn vertically at the waist for 7 consecutive days during waking hours, with data collected at baseline, 1 year, 4 years, and 8–9 years.
The researchers identified 1746 people (59% women, 74% White) aged a mean of 58 years who had undertaken moderate-to-vigorous physical activity based on a metabolic equivalent (MET) of 3 or above.
Almost one third (n=567) of these individuals developed CKD, defined as an estimated glomerular filtration rate (eGFR) below 60 mL/min per 1.73 m2 with at least a 30% drop relative to baseline at a follow-up visit, or end-stage renal disease (eGFR <15 mL/min per 1.73m2) or self-reported kidney failure or death from renal failure.
In one of their calculations, the researchers looked at the association between cumulative average values of moderate-to-vigorous physical activity and CKD development. They divided participants into quartiles based on the number of minutes per week they spent undertaking moderate-to-vigorous physical activity: less than 220.3 minutes (quartile 1), between 220.3 and 328.8 minutes (quartile 2), between 328.8 and 469.2 minutes (quartile 3), and at least 469.2 minutes (quartile 4).
The results showed that the chances of participants developing CKD were significantly lower among people in the third and fourth quartiles for moderate-to-vigorous physical activity than among those in the first quartile, with respective reduced risks of 27% and 31%.
And, in another calculation, patients who increased their weekly moderate-to-vigorous physical activity the most (by at least 63.2 min/week) over a 4-year period had a 33% lower risk for progression to CKD than those whose weekly level of moderate-to-vigorous physical activity decreased the most (by up to 198.3 min/week) .
Putting their data into perspective, the researchers say that someone who does just over an hour of moderate-to-vigorous physical activity every day to reach the highest weekly quartile of exercise could substantially reduce their risk for CKD.
That could be “a brisk walk, slow cycling, jogging, slow sweeping, slow swimming and so on,” the researchers suggest.
They conclude: “[R]egardless of length [of] bout of each [moderate-to-vigorous physical activity], both a longer duration of [moderate-to-vigorous physical activity], and an increase of [moderate-to-vigorous physical activity] duration during follow-up were associated with a reduced risk of progression to CKD in adults with overweight/obesity and [type 2 diabetes].”
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