240173 Self-reported inactivity is associated with faster decline in kidney function in American Indians with chronic kidney disease

Tuesday, November 1, 2011

Marquis Hawkins, PhD , Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
Barbara V. Howard, PhD , Senior Scientist, Medstar Research Institute, Hyattsville, MD
Mary Ann Sevick, ScD, RN , General Internal Medicine, University of Pittsburgh, Pittsburgh, PA
Clareann Bunker, PhD , Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
Linda Fried, MD, MPH , School of Medicine, VA Pittsburgh Healthcare System, Pittsburgh, PA
Vincent Arena , Department of Biostatistics, University of Pittsburg, Pittsburgh, PA
Caroline R. Richardson, MD , Department of Family Medicine / Health Services Research and Development Center for Excellence, University of Michigan / Ann Arbor VA, Ann Arbor, MI
Andrea Kriska, PhD, MS , Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
INTRODUCTION:Individuals with chronic kidney disease (CKD) are less active than their non-CKD counterparts. Few studies have examined the effects of inactivity on CKD progression. The purpose of this analysis was to examine the association between baseline leisure time physical activity (LTPA) and change in kidney function in American Indians (AI) with CKD. METHODS: The Strong Heart Study is a longitudinal study of CVD and its risk factors in 4,549 AIs, aged 45-74 years, from 13 U.S. communities. Individuals were categorized based on their self-reported baseline LTPA levels (no activity, low and high activity). The MDRD formula was used to estimate glomerular filtration rate (eGFR) at baseline and five year follow-up. CKD was defined as an eGFR <60mL/min. Multivariate logistic regression was used to examine the relationship between LTPA and rapid decline in kidney function (>3ml/min per year). RESULTS: CKD was prevalent in 10.5% of the population at baseline (N=458) with 29%, 36%, and 35% reporting no, low, and high levels of LTPA respectively. Compared to highly active individuals, low and inactive individuals had a 2.96 odds (95% CI: 0.93, 9.43) and 3.92 odds (95% CI: 1.16, 13.30) of experiencing rapid declines in kidney function independent of baseline age, eGFR, albuminuria, gender, diabetes and hypertension. CONCLUSION: This was the first study to examine the relationship between activity and change in kidney function in AI's with CKD. Individuals who reported no LTPA at baseline had faster progression of CKD. Future studies should determine whether increasing activity levels slows progression of CKD.

Learning Areas:
Chronic disease management and prevention
Public health or related research

Learning Objectives:
Discuss the role of physical activity in slowing down the progression of chronic diseases.

Keywords: Physical Activity, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because of my experience analyzing physical activity data in large datasets.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.