Physical activity patterns in chronic kidney disease

Background Low levels of physical activity and sedentary behavior are highly prevalent in dialysis patients and are associated with adverse outcomes. However, detailed data on physical activity patterns across the different stages of CKD are limited. The present study aimed to assess physical activity patterns among patients with CKD stages G3, G4, and G5, compared with control subjects. Methods In this prospective cross-sectional observational study, patients with CKD G3 (n = 53), patients with CKD G4-G5 (n = 72), and age-matched controls (n = 70) were included. Physical activity and sedentary behavior were measured with an accelerometer. Participants were categorized based on their moderate-to-vigorous physical activity level into physical activity intensity groups. Multiple regression analysis was conducted to assess the associations of age, gender, BMI, eGFR, marital status, education level, Charlson Comorbidity Index (CCI) score, and diabetes mellitus (DM) with mean daily step count and total sedentary time. Results Daily step count was 6396 in the CKD G3 group, 4396 in the CKD G4-5 group, and 9792 in the control group ( p <.001). Sedentary time was the highest in the CKD G4-5 group (662 min/day), followed by the CKD G3 group (618 min/day) compared to the control group (577 min/day) (p < .001). Most patients with CKD G4-5 (84%) and G3 (59%) were insufficiently active, compared to controls (33%). Multiple regression analyses demonstrated that BMI (t = -2.88, p = .005), eGFR (t = 2.41, p = .017), and CCI score (t = -2.59, p = .011) were associated with daily step count, and BMI (t = 4.32, p < .001), education level (t = -2.81, p = .006), and DM (t = 2.24, p = .027) were associated with total sedentary time. Conclusions Patients with CKD G3 and G4-5 showed lower levels of physical activity and higher levels of sedentary behavior compared to controls. There were significant differences in physical activity between CKD G3 and CKD G4-5, but no significant differences in sedentary behavior between the CKD groups. Most patients with CKD G3 and G4-5 did not meet the international physical activity guidelines. Insights into detailed activity patterns may aid in designing personalized treatment interventions to improve lifestyle.