The aim of this study was to investigate the impact of different levels of physical activity on the prognosis of chronic kidney disease (CKD) patients.

A retrospective investigation in CKD patients admitted to First Medical Center of Chinese PLA General Hospital between May 1, 2018 and May 1, 2019, was performed. Patients with ≥2 hospitalization records were selected for inclusion in the study. Demographic data, clinical indicators, concomitant diseases, pathological information of renal biopsy, treatment plan at the first hospitalization, and renal disease outcome at the last hospitalization were collected. The International Physical Activity Questionnaire (IPAQ) was used to record the physical activity of the CKD patients during follow-up, and the metabolic equivalent of task (MET) was assigned. According to the IPAQ grouping criteria, the patients were divided into low physical activity group, moderate physical activity group, and high physical activity group among which the differences in prognosis of the patients were compared and analyzed.

A total of 266 patients with CKD were enrolled in the study with 64.7% being male. The mean age of the participants was 45.23 ± 13.09 years. The estimated glomerular filtration rate (eGFR) at baseline was 71.16 ± 31.31 ml/(min·1.73 m²). Of all the patients, CKD stage 3 accounted for 32.7% (87/266), CKD stage 1 for 31.5% (84/266), and CKD stage 2 for 24.4%(65/266). There were 39 cases in the low physical activity group, 123 cases in the moderate physical activity group, and 104 cases in the high physical activity group, with an average physical activity score of 3 352±3543. During the last hospitalization, 106 patients experienced a ≥30% decline in eGFR or initiated renal replacement therapy. Kaplan-Meier survival curve analysis revealed that the incidence of major endpoint events was lower in the moderate and high physical activity groups compared with the low physical activity group (P=0.009 and P=0.002, respectively). However, there was no significant difference between the moderate and high physical activity groups (P=0.709). Subgroup analysis showed that patients with CKD stages 1-3 who engaged in moderate or high levels of physical activity had a better prognosis (P=0.009). In contrast, there was no significant difference in prognosis among the three physical activity groups in patients with CKD stages 4-5 (P=0.631). Additionally, among patients with diabetes mellitus, the moderate and high physical activity groups had a better prognosis than the low physical activity group (P=0.002).

The eGFR of the CKD patients in the moderate and high physical activity groups declined slower than that in the low physical activity group. In patients with CKD stage 1 to 3 or CKD patients complicated with diabetes, the prognosis of the moderate and high physical activity groups was better than that of the low physical activity group.