Tasaki Hikari, Kosugi Takaaki, Eriguchi Masahiro, Yoshida Hisako, Uemura Takayuki, Tamaki Hiroyuki, Furuyama Riri, Nishimoto Masatoshi, Matsui Masaru, Samejima Ken-Ichi, Iseki Kunitoshi, Asahi Koichi, Yamagata Kunihiro, Konta Tsuneo, Fujimoto Shouichi, Narita Ichiei, Kasahara Masato, Shibagaki Yugo, Moriyama Toshiki, Kondo Masahide, Watanabe Tsuyoshi, Tsuruya Kazuhiko
Department of Nephrology, Nara Medical University, Nara, Japan.
Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Hypertens Res. 2025 Aug 20. doi: 10.1038/s41440-025-02335-4.
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.
众所周知，运动可降低心血管疾病风险和死亡率。然而，针对慢性肾脏病（CKD）患者的研究有限。本研究利用基于人群的大型数据，调查有和没有CKD的个体之间运动习惯对全因死亡率和心血管死亡率影响的差异。本研究纳入了2008年至2014年进行的日本特定健康检查（J-SHC）研究的参与者。感兴趣的暴露因素是自我报告的日常运动习惯。基于CKD状态，使用Cox回归分析检查运动习惯与全因死亡率和心血管死亡率之间的关联。在469,466名参与者中，84,508名（18.0%）患有CKD，39,343名（46.6%）进行运动。在44.0个月的中位随访期内，非CKD队列和CKD队列中分别有3932名（2.76/1000人年）和1505名（5.09/1000人年）参与者死亡。运动习惯与非CKD队列和CKD队列中较低的全因死亡风险相关，调整后的风险比和95%置信区间分别为0.80（0.75-0.86）和0.70（0.63-0.78）。运动习惯对死亡率的影响在CKD组中更大（交互作用P=0.02）。心血管死亡率也观察到类似结果。与没有CKD的个体相比，规律运动与CKD个体全因死亡率和心血管死亡率降低的关联更强。我们的研究强调，轻度CKD个体比没有CKD的个体更需要优先养成运动习惯。
