Physical activity is associated with lower risks of many chronic diseases, but whether weekly MVPA patterns are related to kidney and urinary tract disease risk remains uncertain. We examined accelerometer-derived MVPA patterns and incident kidney and urinary tract diseases in the UK Biobank. We included 83,050 UK Biobank participants with valid 7-day wrist-worn accelerometer data and no baseline cancer. Participants were classified by weekly MVPA as inactive (<150 min/week), regularly active (≥150 min/week without concentration within 1–2 days), or weekend warrior (≥150 min/week with ≥50% accumulated within 1–2 days). The primary outcome was a composite of incident kidney and urinary tract diseases, excluding prostate and male genital disorders. Secondary outcomes included renal failure-related diseases, stone or obstructive urinary tract outcomes, and lower urinary tract or bladder disorders. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic splines assessed dose-response associations with total weekly MVPA. Compared with inactivity, both regularly active and weekend warrior patterns were associated with lower risks of the primary composite outcome. Similar inverse associations were observed for acute renal failure, chronic renal failure, obstructive uropathy, kidney/ureter calculus, other bladder disorders, and other urinary disorders. For example, HRs for acute renal failure were 0.80 (95% CI, 0.71–0.90) for regularly active participants and 0.75 (95% CI, 0.68–0.82) for weekend warriors. Total weekly MVPA showed inverse dose-response associations with several outcomes. Among participants with ≥150 min/week MVPA, weekend warrior and regularly active patterns showed no clear difference after adjustment for total MVPA volume. Accelerometer-derived MVPA was associated with lower risks of incident kidney and urinary tract diseases. These associations were observed whether MVPA was concentrated within 1–2 days or distributed more regularly across the week.
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