Study: Exercise intervention slows kidney function decline in older sedentary adults
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Key takeaways:
- Patients who had exercise intervention walked an average 291 more steps daily vs. patients with health education alone.
- Intervention was not significantly associated with changes in biomarkers of kidney health.
A structured exercise intervention slowed kidney function decline in older adults and higher activity was associated with overall health improvements, research shows.
“Physical activity is beneficial in elderly patients with chronic kidney disease (CKD) and that high-intensity exercise can transiently improve kidney health in patients with moderate CKD,” Anoop Sheshadri, MD, MAS, of the departments of medicine at the University of California San Francisco and the San Francisco VA Health Care System, wrote along with colleagues. “We sought to determine whether there were specific biomarkers of kidney health that were affected by exercise and physical activity intervention to investigate potential mechanisms for this positive impact on kidney decline.”
In the Lifestyle Interventions for Elders study, researchers examined a group of 1,381 randomly selected sedentary adults aged 70 to 89 years. Patients took part in either a structured, 2-year, moderate-intensity exercise intervention or health education.
The study measured physical activity by step count, and 14 serum and urine biomarkers of kidney health were assessed at baseline, 1 year and 2 years.
According to results, patients assigned to the exercise intervention walked an average 291 more steps per day compared with counterparts in the health education group. The intervention, however, was not significantly associated with changes in biomarkers of kidney health, the researchers noted. In observational analyses, individuals in the highest quartile of activity (at least 3,470 steps per day) showed substantial improvements in various biomarkers. Notable changes included reductions in urine albumin, alpha-1-microglobulin, trefoil factor-3, epidermal growth factor, uromodulin, interleukin-18, neutrophil gelatinase-associated lipocalin, monocyte chemoattractant protein-1, clusterin, serum tumor necrosis factor (TNF) receptor-1, and TNF receptor-2.
While the intervention did not improve any of the 14 measures of kidney tubule health, higher activity was independently associated with improvements in several domains, particularly the slope of eGFR during a 2-year period, as well as tubular injury and generalized inflammation. The study also highlighted links between higher exercise and enhancements in biomarkers of glomerular injury, tubular function/repair, tubular injury, generalized inflammation, and tubulointerstitial repair/fibrosis, according to Sheshadri and colleagues.
“These results help to clarify the overall impact of physical activity on kidney decline,” the authors wrote. “Future research should explore whether these same biomarkers of kidney health change over time as a natural course of aging and, if so, whether physical activity and exercise can slow the natural process of aging in the kidney.”
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