Key result
Moderate physical activity links to ~73% lower mortality in women with stage 4-5 CKD, but not men.
Why the study?
The association between self-reported physical activity and all-cause mortality in ambulatory patients with stage 4–5 CKD including those on maintenance dialysis was investigated.
Does moderate or high physical activity reduce all-cause mortality in ambulatory patients with stage 4-5 CKD compared to inactivity?
Cohort (n=374)
Yes
Does moderate or high physical activity reduce all-cause mortality in ambulatory patients with stage 4-5 CKD compared to inactivity?
Moderate physical activity is associated with a significant reduction in all-cause mortality among women with stage 4-5 CKD, but this benefit was not observed in men.
Should not yet change activity counseling in advanced CKD; hypothesis-generating for sex-specific effects needing RCT validation.
(1) Background: The purpose of this article was to investigate the association between self-reported physical activity (PA) and all-cause mortality in ambulatory patients with chronic kidney disease (CKD), stage 4–5 including maintenance dialysis. (2) Methods: Ambulatory patients with CKD (eGFR < 30 mL/min/1.73 m2) with conservative treatment or chronic dialysis were included. PA was assessed using the Saltin–Grimby Physical Activity Level Scale. A Cox proportional hazards regression model––adjusted for age, sex, plasma–albumin, body mass index, socioeconomic status, and treatment––was applied. (3) Results: Participants (n = 374) were followed 39 ± 15 months from entry to death or censoring. Throughout the study period of 39 months, 156 deaths (42%) were registered. Regarding physical activity, 128 (34%) of the participants were inactive, 212 (57%) were moderately active, and 34 (9%) were highly or vigorously active. Moderate PA was associated with a decreased mortality risk in women (n = 150) compared to inactivity (HR 0.27 (0.15; 0.51), p < 0.001), whereas a high/vigorous level of PA was not significantly associated with mortality risk compared to inactivity. In men (n = 224), the associations between PA levels and mortality risk were not significant. (4) Conclusions: Moderate PA was associated with reduced all-cause mortality in ambulatory women with stage 4–5 CKD with or without maintenance dialysis treatment. Physical activity was not significantly associated with mortality in men.
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Mølsted et al. (2021) conducted a cohort in Chronic kidney disease (stage 4-5) (n=374). Moderate physical activity vs. Physical inactivity was evaluated on All-cause mortality (HR 0.27, 95% CI 0.15-0.51, p=<0.001). Moderate physical activity was associated with a significantly decreased risk of all-cause mortality compared to inactivity in women with stage 4-5 chronic kidney disease (HR 0.27), but not in men.
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