Association of Physical Activity with Abdominal Aortic Calcification in Chronic Kidney Disease: A Cross-Sectional Study

INTRODUCTION: Limited studies have investigated the impact of physical activity (PA) on vascular calcification (VC) in patients with chronic kidney disease (CKD). Therefore, this cross-sectional study aims to investigate the link between PA and abdominal aortic calcification (AAC) in CKD patients. METHODS: This study involved 571 participants with CKD from the 2013-2014 National Health and Nutrition Examination Survey (NHANES). PA was measured by total weekly time (hours) and MET levels. Weighted Poisson regression analyses (both univariate and multivariable) were conducted to investigate the associations between PA and AAC. Subgroup analyses were performed to detect interaction effects, and restricted cubic splines were applied to assess potential nonlinear relationships. RESULTS: Longer weekly PA time and higher MET levels were associated with reduced AAC prevalence and severity. Each 1-hour increase in PA was associated with a 1% lower prevalence of AAC (PR = 0.99, 95% CI 0.98-0.99, p=0.002), while the high MET group showed a 29% lower prevalence compared to the inactive group (PR = 0.71, 95% CI: 0.55-0.92, p = 0.01). These associations were independent of traditional and CKD-specific risk factors. Subgroup analyses revealed no significant interaction effects, and restricted cubic spline models did not indicate a nonlinear association. CONCLUSION: Our study demonstrated that PA was independently and inversely associated with AAC burden in patients with CKD. These findings highlight the potential value of PA as a modifiable lifestyle factor in the comprehensive management of CKD.