Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk.

Tytuł:: Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk.
Autorzy:: Böhm M; Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 1, 66421, Homburg/Saar, Germany. .
Schumacher H; Statistical Consultant, 55218, Ingelheim, Germany.
Werner C; Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 1, 66421, Homburg/Saar, Germany.
Teo KK; Department of Medicine, Population Health Research Institute, McMaster University, Hamilton, ON, L8L 2X2, Canada.
Lonn EM; Department of Medicine, Population Health Research Institute, McMaster University, Hamilton, ON, L8L 2X2, Canada.
Mahfoud F; Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 1, 66421, Homburg/Saar, Germany.
Speer T; Klinik für Innere Medizin IV, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str.1, Homburg/Saar, Germany.
Mancia G; University of Milano-Bicocca, Istituto Clinico Universitario Policlinico di Monza, Piazza dell'Ateneo Nuovo, 1, Milan, Italy.
Redon J; Hypertension Unit, Hospital CIínico Universitario, University of Valencia, Av. de Blasco Ibáñez, 13, València, Spain.; CIBERObn, Institute of Health Carlos III, Madrid, Spain.
Schmieder RE; Department of Nephrology and Hypertension, University Hospital, Friedrich-Alexander University, Erlangen/Nuremberg, Germany.
Sliwa K; Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa & IIDMM, University of Cape Town, Cape Town, South Africa.
Marx N; Department of Internal Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen, Germany.
Weber MA; Downstate College of Medicine, State University of New York, 450 Clarkson Ave, Brooklyn, NY, USA.
Laufs U; Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
Williams B; 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.
Yusuf S; Department of Medicine, Population Health Research Institute, McMaster University, Hamilton, ON, L8L 2X2, Canada.
Mann JFE; KfH Kidney Centre, München-Schwabing, Minich, Germany.; Department of Nephrology and Hypertension, University Hospital, Friedrich-Alexander University, Schlossplatz 4, Erlangen, Germany.
Źródło:: Cardiovascular diabetology [Cardiovasc Diabetol] 2022 Jan 20; Vol. 21 (1), pp. 12. Date of Electronic Publication: 2022 Jan 20.
Typ publikacji:: Comparative Study; Journal Article; Multicenter Study; Observational Study; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: London : BioMed Central, [2002-
MeSH Terms:: Exercise*
Healthy Lifestyle*
Risk Reduction Behavior*
Cardiovascular Diseases/*prevention & control
Diabetes Mellitus/*therapy
Diabetic Nephropathies/*therapy
Kidney Failure, Chronic/*prevention & control
Renal Insufficiency, Chronic/*therapy
Aged ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/physiopathology ; Databases, Factual ; Diabetes Mellitus/diagnosis ; Diabetes Mellitus/mortality ; Diabetes Mellitus/physiopathology ; Diabetic Nephropathies/diagnosis ; Diabetic Nephropathies/mortality ; Diabetic Nephropathies/physiopathology ; Female ; Glomerular Filtration Rate ; Heart Disease Risk Factors ; Humans ; Kidney/physiopathology ; Kidney Failure, Chronic/diagnosis ; Kidney Failure, Chronic/mortality ; Kidney Failure, Chronic/physiopathology ; Male ; Middle Aged ; Protective Factors ; Randomized Controlled Trials as Topic ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/mortality ; Renal Insufficiency, Chronic/physiopathology ; Risk Assessment ; Time Factors ; Treatment Outcome
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Contributed Indexing:: Keywords: Cardiovascular outcomes; Physical activity; Renal outcomes; Secondary prevention
Molecular Sequence:: ClinicalTrials.gov NCT00153101; NCT00015310
Entry Date(s):: Date Created: 20220121 Date Completed: 20220228 Latest Revision: 20220518
Update Code:: 20240105
PubMed Central ID:: PMC8772075
DOI:: 10.1186/s12933-021-01429-w
PMID:: 35057807
: Czasopismo naukowe

Pełny tekst

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: Analyses were done with Cox regression analysis, mixed models for repeated measures, ANOVA and χ 2 -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.
(© 2021. The Author(s).)

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