Domain-specific Physical Activity & Chronic Kidney Disease In Diabetic Individuals

Diabetes-related nephropathy stands as a critical health concern due to escalated mortality rates and the substantial financial implications of healthcare costs. Particularly noteworthy is the synergy between diabetes and hypertension, responsible for more than 80% of cases of kidney disease. Consequently, the prevention and management of renal complications among individuals with diabetes assume paramount importance, addressing both individual health outcomes and broader societal implications. PURPOSE: We hypothesized that diabetic patients engaging in physical activity (PA) above the recommended levels would be associated with a lower prevalence of chronic kidney disease (CKD). This study aimed to examine (1) the relationship between domain-specific PA and prevalence of CKD and (2) meeting PA and resistance exercise (RE) guideline with prevalence of CKD in individuals with diabetes. METHODS: The study analyzed data from the 2019-2021 Korean National Health and Nutrition Examination Survey, including 22,559 participants. Of which 2,381 adults with diabetes were finally selected. PA was assessed using Global Physical Activity Questionnaire (GPAQ). CKD was defined as having an estimated glomerular filtration rate < 60 mL/min/1.73 or the urinary albumin to creatinine ratio 30 mg/g or a physician’s diagnosis. Logistic regression models were used to assess the association between compliance with the American Diabetes Association (ADA)’s PA guidelines and CKD, with further stratification according to known CKD risk factors. RESULTS: Individuals with diabetes who met the PA guideline with leisure PA and resistance exercise (RE) guideline had a 45% reduction in CKD risk (OR: 0.55, 95% CI 0.34-0.89). This reduction was particularly pronounced in individuals with lower BMI (OR: 0.31, 95% CI 0.15-0.65) and lower HbA1c(OR:0.31, 95% CI 0.10-0.93). However, individuals who met the PA guideline with work-related PA and RE guideline did not have lower risk of CKD (OR: 1.46, 95% CI 0.44-4.82). CONCLUSION: Meeting PA and RE guidelines are associated with lower risk of CKD in individuals with diabetes. These findings underscore the potential benefits of leisure PA and RE in the prevention of CKD in individuals with diabetes. Yonsei Signature Research Cluster Project (2023-22-0017)