The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study

Objective To examine whether lifestyle factors, including sedentary time and physical activity, could independently contribute to risk of end-stage renal disease (ESRD).Study design Case-cohort study.Setting South-eastern USA.Participants The Southern Community Cohort Study recruited ~86 000 black a...

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Main Authors: William J Blot, Jacob Taylor, Mindy Pike, Edmond Kabagambe, Thomas G Stewart, Cassianne Robinson-Cohen, Jennifer Morse, Elvis Akwo, Khaled Abdel-Kader, Edward D Siew, T Alp Ikizler, Loren Lipworth
Format: Article
Language:English
Published: BMJ Publishing Group 2019-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/8/e030661.full
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author William J Blot
Jacob Taylor
Mindy Pike
Edmond Kabagambe
Thomas G Stewart
Cassianne Robinson-Cohen
Jennifer Morse
Elvis Akwo
Khaled Abdel-Kader
Edward D Siew
T Alp Ikizler
Loren Lipworth
author_facet William J Blot
Jacob Taylor
Mindy Pike
Edmond Kabagambe
Thomas G Stewart
Cassianne Robinson-Cohen
Jennifer Morse
Elvis Akwo
Khaled Abdel-Kader
Edward D Siew
T Alp Ikizler
Loren Lipworth
author_sort William J Blot
collection DOAJ
description Objective To examine whether lifestyle factors, including sedentary time and physical activity, could independently contribute to risk of end-stage renal disease (ESRD).Study design Case-cohort study.Setting South-eastern USA.Participants The Southern Community Cohort Study recruited ~86 000 black and white participants from 2002 to 2009. We assembled a case cohort of 692 incident ESRD cases and a probability sample of 4113 participants.Predictors Sedentary time was calculated as hours/day from daily sitting activities. Physical activity was calculated as metabolic equivalent (MET)-hours/day from engagement in light, moderate and vigorous activities.Outcomes Incident ESRD.Results At baseline, among the subcohort, mean (SD) age was 52 (8.6) years, and median (25th, 75th centile) estimated glomerular filtration rate (eGFR) was 102.8 (85.9–117.9) mL/min/1.73 m2. Medians (25th–75th centile) for sedentary time and physical activity were 8.0 (5.5–12.0) hours/day and 17.2 (8.7–31.9) MET-hours/day, respectively. Median follow-up was 9.4 years. We observed significant interactions between eGFR and both physical activity and sedentary behaviour (p<0.001). The partial effect plot of the association between physical activity and log relative hazard of ESRD suggests that ESRD risk decreases as physical activity increases when eGFR is 90 mL/min/1.73 m2. The inverse association is most pronounced at physical activity levels >27 MET-hours/day. High levels of sitting time were associated with increased ESRD risk only among those with reduced kidney function (eGFR ≤30 mL/min/1.73 m2); this association was attenuated after excluding the first 2 years of follow-up.Conclusions In a population with a high prevalence of chronic kidney disease risk factors such as hypertension and diabetes, physical activity appears to be associated with reduced risk of ESRD among those with preserved kidney function. A positive association between sitting time and ESRD observed among those with advanced kidney disease is likely due to reverse causation.
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spelling doaj-art-076f1b0115f44d91bd561d78820d28282024-11-26T21:10:09ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2019-030661The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort StudyWilliam J Blot0Jacob Taylor1Mindy Pike2Edmond Kabagambe3Thomas G Stewart4Cassianne Robinson-Cohen5Jennifer Morse6Elvis Akwo7Khaled Abdel-Kader8Edward D Siew9T Alp Ikizler10Loren Lipworth111Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USAObjective To examine whether lifestyle factors, including sedentary time and physical activity, could independently contribute to risk of end-stage renal disease (ESRD).Study design Case-cohort study.Setting South-eastern USA.Participants The Southern Community Cohort Study recruited ~86 000 black and white participants from 2002 to 2009. We assembled a case cohort of 692 incident ESRD cases and a probability sample of 4113 participants.Predictors Sedentary time was calculated as hours/day from daily sitting activities. Physical activity was calculated as metabolic equivalent (MET)-hours/day from engagement in light, moderate and vigorous activities.Outcomes Incident ESRD.Results At baseline, among the subcohort, mean (SD) age was 52 (8.6) years, and median (25th, 75th centile) estimated glomerular filtration rate (eGFR) was 102.8 (85.9–117.9) mL/min/1.73 m2. Medians (25th–75th centile) for sedentary time and physical activity were 8.0 (5.5–12.0) hours/day and 17.2 (8.7–31.9) MET-hours/day, respectively. Median follow-up was 9.4 years. We observed significant interactions between eGFR and both physical activity and sedentary behaviour (p<0.001). The partial effect plot of the association between physical activity and log relative hazard of ESRD suggests that ESRD risk decreases as physical activity increases when eGFR is 90 mL/min/1.73 m2. The inverse association is most pronounced at physical activity levels >27 MET-hours/day. High levels of sitting time were associated with increased ESRD risk only among those with reduced kidney function (eGFR ≤30 mL/min/1.73 m2); this association was attenuated after excluding the first 2 years of follow-up.Conclusions In a population with a high prevalence of chronic kidney disease risk factors such as hypertension and diabetes, physical activity appears to be associated with reduced risk of ESRD among those with preserved kidney function. A positive association between sitting time and ESRD observed among those with advanced kidney disease is likely due to reverse causation.https://bmjopen.bmj.com/content/9/8/e030661.full
spellingShingle William J Blot
Jacob Taylor
Mindy Pike
Edmond Kabagambe
Thomas G Stewart
Cassianne Robinson-Cohen
Jennifer Morse
Elvis Akwo
Khaled Abdel-Kader
Edward D Siew
T Alp Ikizler
Loren Lipworth
The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study
BMJ Open
title The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study
title_full The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study
title_fullStr The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study
title_full_unstemmed The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study
title_short The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study
title_sort association of exercise and sedentary behaviours with incident end stage renal disease the southern community cohort study
url https://bmjopen.bmj.com/content/9/8/e030661.full
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