Moderate-intensity physical activity can slow decline in estimated glomerular filtration rate (eGFR) in sedentary older adults, a new study finds.
In the LIFE (Lifestyle Interventions and Independence For Elders) trial, investigators randomly assigned 1199 adults aged 70 to 89 years with mobility limitations to moderate-intensity physical activity or a health education workshop. Of the cohort, two-thirds had an eGFR less than 60 mL/min/1.73 m2, using cystatin C as the filtration marker. The activity component targeted 30 minutes of walking daily as well as 10 minutes of lower-extremity strength training, 10 minutes of balance training, and large-muscle flexibility exercises. This analysis was an ancillary study of the original trial.
Over 2 years, the physical activity and exercise intervention led to mean 0.96 mL/min/1.73 m2 less decline in eGFR compared with a health education workshop, Michael G. Shlipak, MD, MPH, of San Francisco VA Health Care System in California, and colleagues reported in JAMA Internal Medicine.
Patients with the highest quartile of step count (3470 steps/d or more) had an approximately 2 mL/min/1.73 m2 slower decline in eGFR and, in a fully adjusted model, a significant 38% decreased odds of rapid decline compared with patients with the lowest quartile of step count (1567 steps/d or less).
Of the 1199 older adults, 29.1% experienced rapidly declining kidney function (defined as 6.7% per year), including 25.9% of the physical activity group and 32.2% of the health education group. The exercise intervention decreased the odds of rapid eGFR decline by a significant 21% compared with the control group. The effect appeared stronger among patients without cardiovascular disease.
“Clinicians should consider prescribing physical activity and moderate-intensity exercise for older adults to slow the rate of decline of kidney function,” according to Dr Shlipak’s team. They cautioned that exercise sessions need to be individualized.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Shlipak MG, Sheshadri A, Hsu FC, et al. Effect of structured, moderate exercise on kidney function decline in sedentary older adults: an ancillary analysis of the LIFE study randomized clinical trial. JAMA Intern Med. Published online May 2, 2022. doi:10.1001/jamainternmed.2022.1449