Physical activity and risk of end-stage kidney disease in the Singapore Chinese Health Study

AimTo explore the relationship between physical activity and risk of end-stage kidney disease (ESKD). MethodsWe analysed data on a prospective cohort of 59552 Chinese adults aged 45-74 years enrolled in the Singapore Chinese Health Study. Information on physical activity was collected with a structured questionnaire. Physically active individuals were defined as those who engaged in any moderate activities for 2h or more per week and any strenuous activities 30min or more per week. Incident ESKD was identified via record linkage with the Singapore Registry of Birth and Death and Singapore Renal Registry. Cox proportional hazards regression method was used for analysis for risk of incident ESKD alone or ESKD plus death associated with physical activity. ResultsDuring a median follow-up of 15.3 years, a total of 642 incident ESKD occurred, and 9808 study participants died. A 24% lower adjusted risk of ESKD (hazard ratio: 0.76; 95% confidence interval: 0.62-0.93) was associated with moderate or strenuous physical activities compared with no regular physical activity. This association appeared to be dose dependent with the lowest risk for subjects at highest intensity of physical activity (P trend <0.003). Similar results were observed for risk of ESKD plus death. ConclusionHigher levels of physical activity are associated with lower risk of ESKD. Our findings highlight the role of physical activity for prevention of ESKD, which deserves further evaluation in intervention trials. Summary at a Glance Physical inactivity is recognized as one of the leading risk factors of deaths and disability predominantly from cardiovascular disease. This study extends this to examine the relationship between physical exercise and the development of ESKD.