Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk
Cardiovascular Diabetology, vol. 21, pp. 12
Abstract
BACKGROUND: Guidelines recommend physical activity to reduce cardiovascular (CV) events. The association between physical activity and progression of chronic kidney disease (CKD) with and without diabetes is unknown. We assessed the association of self-reported physical activity with renal and CV outcomes in high-risk patients aged ≥ 55 years over a median follow-up of 56 months in post-hoc analysis of a previously randomized trial program. METHODS: -test. 31,312 patients, among them 19,664 with and 11,648 without diabetes were analyzed. RESULTS: Physical activity was inversely associated with renal outcomes (doubling of creatinine, end-stage kidney disease (ESRD)) and CV outcomes (CV death, myocardial infarction, stroke, heart failure hospitalization). Moderate activity (at least 2 times/week to every day) was associated with lower risk of renal outcomes and lower incidence of new albuminuria (p < 0.0001 for both) compared to lower exercise levels. Similar results were observed for those with and without diabetes without interaction for renal outcomes (p = 0.097-0.27). Physical activity was associated with reduced eGFR decline with a moderate association between activity and diabetes status (p = 0.05). CONCLUSIONS: Moderate physical activity was associated with improved kidney outcomes with a threshold at two sessions per week. The association of physical activity with renal outcomes did not meaningfully differ with or without diabetes but absolute benefit of activity was even greater in people with diabetes. Thus, risks were similar between those with diabetes undertaking high physical activity and those without diabetes but low physical activity. CLINICAL TRIAL REGISTRATION: http://clinicaltrials.gov.uniqueidentifier :NCT00153101.
Authors 17
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Michael Böhm corresponding
Universitätsklinikum des Saarlandes · Saarland University
Affiliation as printed
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 1, 66421, Homburg/Saar, Germany. michael.boehm@uks.eu
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 1, 66421, Homburg/Saar, Germany
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Affiliation as printed
Statistical Consultant, 55218, Ingelheim, Germany
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Universitätsklinikum des Saarlandes · Saarland University
Affiliation as printed
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 1, 66421, Homburg/Saar, Germany
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Population Health Research Institute · McMaster University
Affiliation as printed
Department of Medicine, Population Health Research Institute, McMaster University, Hamilton, ON, L8L 2X2, Canada
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Population Health Research Institute · McMaster University
Affiliation as printed
Department of Medicine, Population Health Research Institute, McMaster University, Hamilton, ON, L8L 2X2, Canada
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Universitätsklinikum des Saarlandes · Saarland University
Affiliation as printed
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 1, 66421, Homburg/Saar, Germany
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Universitätsklinikum des Saarlandes · Saarland University
Affiliation as printed
Klinik für Innere Medizin IV, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str.1, Homburg/Saar, Germany
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Affiliation as printed
University of Milano-Bicocca, Istituto Clinico Universitario Policlinico di Monza, Piazza dell'Ateneo Nuovo, 1, Milan, Italy
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Universitat de València · Instituto de Salud Carlos III · Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition · Hospital Clínico Universitario de Valencia
Affiliation as printed
CIBERObn, Institute of Health Carlos III, Madrid, Spain
Hypertension Unit, Hospital CIínico Universitario, University of Valencia, Av. de Blasco Ibáñez, 13, València, Spain
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Friedrich-Alexander-Universität Erlangen-Nürnberg · Universitätsklinikum Erlangen
Affiliation as printed
Department of Nephrology and Hypertension, University Hospital, Friedrich-Alexander University, Erlangen/Nuremberg, Germany
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Affiliation as printed
Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa & IIDMM, University of Cape Town, Cape Town, South Africa
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Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Department of Internal Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen, Germany
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State University of New York · SUNY Downstate Health Sciences University
Affiliation as printed
Downstate College of Medicine, State University of New York, 450 Clarkson Ave, Brooklyn, NY, USA
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Affiliation as printed
Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
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National Institute for Health and Care Research · UCL Biomedical Research Centre · University College London
Affiliation as printed
University College London (UCL), Institute of Cardiovascular Science, National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre, 149 Tottenham Court Road, London, UK
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Population Health Research Institute · McMaster University
Affiliation as printed
Department of Medicine, Population Health Research Institute, McMaster University, Hamilton, ON, L8L 2X2, Canada
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Friedrich-Alexander-Universität Erlangen-Nürnberg · Universitätsklinikum Erlangen · München Klinik Schwabing
Affiliation as printed
Department of Nephrology and Hypertension, University Hospital, Friedrich-Alexander University, Schlossplatz 4, Erlangen, Germany
KfH Kidney Centre, München-Schwabing, Minich, Germany
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