Impact of exercise on all-cause and cardiovascular mortality in non-dialysis chronic kidney disease: the Japan specific health checkups (J-SHC) study.

Exercise is well known to reduce the risk of cardiovascular diseases and mortality. However, studies in individuals with chronic kidney disease (CKD) are limited. This study used large population-based data to investigate the differences in the impact of exercise habits on all-cause and cardiovascular mortality between individuals with and without CKD. This study included participants from the Japan Specific Health Checkups (J-SHC) Study conducted between 2008 and 2014. The exposure of interest was self-reported daily exercise habits. The association between exercise habits and all-cause and cardiovascular mortality was examined using Cox regression analysis based on the CKD status. Of the 469,466 participants, 84,508 (18.0%) had CKD, and 39,343 (46.6%) exercised. During the median follow-up period of 44.0 months, 3932 (2.76/1000 person-years) and 1505 (5.09/1000 person-years) participants died in the non-CKD and CKD cohorts, respectively. Exercise habits were associated with a lower risk of all-cause mortality in the non-CKD and CKD cohorts, with adjusted hazard ratios and 95% confidence intervals of 0.80 (0.75-0.86) and 0.70 (0.63-0.78), respectively. The effect of exercise habits on mortality was greater in the CKD group (P for interaction = 0.02). Similar results were observed for cardiovascular mortality. Regular exercise was more strongly associated with decreased all-cause and cardiovascular mortality in individuals with CKD than in those without. Our study highlights the need for individuals with mild CKD to prioritize exercise habits over those without CKD.