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Clinical Research
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Physical Activity and Change in Estimated GFR among Persons with CKD

Cassianne Robinson-Cohen, Alyson J. Littman, Glen E. Duncan, Noel S. Weiss, Michael C. Sachs, John Ruzinski, John Kundzins, Denise Rock, Ian H. de Boer, T. Alp Ikizler, Jonathan Himmelfarb and Bryan R. Kestenbaum
JASN February 2014, 25 (2) 399-406; DOI: https://doi.org/10.1681/ASN.2013040392
Cassianne Robinson-Cohen
*Kidney Research Institute and
†Department of Epidemiology, University of Washington, Seattle, Washington;
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Alyson J. Littman
†Department of Epidemiology, University of Washington, Seattle, Washington;
‡Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington;
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Glen E. Duncan
†Department of Epidemiology, University of Washington, Seattle, Washington;
§Nutritional Science Program, University of Washington, Seattle, Washington;
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Noel S. Weiss
†Department of Epidemiology, University of Washington, Seattle, Washington;
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Michael C. Sachs
*Kidney Research Institute and
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John Ruzinski
*Kidney Research Institute and
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John Kundzins
*Kidney Research Institute and
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Denise Rock
*Kidney Research Institute and
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Ian H. de Boer
*Kidney Research Institute and
†Department of Epidemiology, University of Washington, Seattle, Washington;
‖Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington;
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T. Alp Ikizler
¶Veterans Affairs Tennessee Valley Healthcare System Nashville, Tennessee; and
**Division of Nephrology, Vanderbilt University, Nashville, Tennessee
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Jonathan Himmelfarb
*Kidney Research Institute and
¶Veterans Affairs Tennessee Valley Healthcare System Nashville, Tennessee; and
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Bryan R. Kestenbaum
*Kidney Research Institute and
†Department of Epidemiology, University of Washington, Seattle, Washington;
‖Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington;
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Abstract

Physical activity may counteract metabolic disturbances that promote the progression of CKD. To address this concept, we performed a longitudinal cohort study of 256 participants in the Seattle Kidney Study, a clinic-based study of CKD. Participants with an estimated GFR (eGFR) of 15–59 ml/min per 1.73 m2 at baseline were eligible for the study. Physical activity was quantified using the Four-Week Physical Activity History Questionnaire. We used generalized estimating equations to test associations of physical activity with change in eGFR determined by longitudinal measurements of serum cystatin C. Mean baseline eGFR was 42 ml/min per 1.73 m2. During a median 3.7 years of follow-up, the mean change in eGFRcystatin C was −7.6% per year (interquartile range, −16.8%, 4.9% per year). Participants who reported >150 minutes of physical activity per week had the lowest rate of eGFRcystatin C loss (mean −6.2% per year compared with −9.6% per year among inactive participants). In adjusted analyses, each 60-minute increment in weekly physical activity duration associated with a 0.5% slower decline per year in eGFR (95% confidence interval, 0.02 to 0.98; P=0.04). Results were similar in sensitivity analyses restricted to participants without cardiovascular disease or diabetes, or to participants with moderate/high physical function. After adjustment for eGFR at the time of questionnaire completion, physical activity did not associate with the incidence of ESRD (n=34 events). In summary, higher physical activity levels associated with slower rates of eGFR loss in persons with established CKD.

  • Copyright © 2014 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 25 (2)
Journal of the American Society of Nephrology
Vol. 25, Issue 2
February 2014
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Physical Activity and Change in Estimated GFR among Persons with CKD
Cassianne Robinson-Cohen, Alyson J. Littman, Glen E. Duncan, Noel S. Weiss, Michael C. Sachs, John Ruzinski, John Kundzins, Denise Rock, Ian H. de Boer, T. Alp Ikizler, Jonathan Himmelfarb, Bryan R. Kestenbaum
JASN Feb 2014, 25 (2) 399-406; DOI: 10.1681/ASN.2013040392

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Physical Activity and Change in Estimated GFR among Persons with CKD
Cassianne Robinson-Cohen, Alyson J. Littman, Glen E. Duncan, Noel S. Weiss, Michael C. Sachs, John Ruzinski, John Kundzins, Denise Rock, Ian H. de Boer, T. Alp Ikizler, Jonathan Himmelfarb, Bryan R. Kestenbaum
JASN Feb 2014, 25 (2) 399-406; DOI: 10.1681/ASN.2013040392
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