Exercise Reduces the Risk of Chronic Kidney Disease in Individuals with Nonalcoholic Fatty Liver Disease: A Nationwide Cohort Study - 01/06/22

Doi : 10.1016/j.diabet.2022.101362

Chan-Young Jung ¹, Ho Soo Chun ², Minjong Lee ², Hee Byung Koh ¹, Keun Hyung Park ³, Young Su Joo ¹, Hyung Woo Kim ¹, Sang Hoon Ahn ^1,⁴, Jung Tak Park ^1,^5,^⁎ , Seung Up Kim ^1,^4,^⁎
¹ Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea
² Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Republic of Korea
³ Department of Internal Medicine, CHA Ilsan Medical Center, CHA Universigty, Goyang-si, Gyeonggi-do, Republic of Korea
⁴ Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
⁵ Institute of Kidney Disease Research, Yonsei University, College of Medicine, Seoul, Republic of Korea

^⁎Corresponding author: Jung Tak Park. Yonsei University, College of Medicine, Department of Internal Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea, Tel.: +82-2-2228-2281; Fax: +82-2-393-6884Yonsei University, College of MedicineDepartment of Internal MedicineYonsei-ro 50-1, Seodaemun-guSeoulRepublic of Korea^⁎⁎Corresponding author: Seung Up Kim. Yonsei University, College of Medicine, Department of Internal Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea, Tel.: +82-2-2228-1944; Fax: +82-2-393-6884Yonsei University, College of MedicineDepartment of Internal MedicineYonsei-ro 50-1, Seodaemun-guSeoulRepublic of Korea

Sous presse. Manuscrit accepté. Disponible en ligne depuis le Wednesday 01 June 2022
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

ABSTRACT

Aims

Recent studies of individuals with nonalcoholic fatty liver disease (NAFLD) have indicated benefits of exercise in improving outcomes. We investigated whether exercise reduces the risk of chronic kidney disease (CKD) in individuals with NAFLD.

Methods

A total of 7,275 participants from the Korea National Health and Nutrition Examination Survey (KNHANES) cohort, and 40,418 participants with NAFLD from the National Health Insurance Service (NHIS) cohort were included for the cross-sectional and longitudinal analyses, respectively. For the cross-sectional analysis, the primary outcome was prevalent CKD, defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m². For the longitudinal analysis, the primary outcome was incident CKD, defined as the occurrence of eGFR <60 mL/min/1.73m² or proteinuria (≥trace) on two consecutive measurements during follow-up.

Results

In the KNHANES cohort, prevalent CKD was observed in 229 (6.1%), 48 (2.6%), and 36 (2.1%) participants in the 0, 1-2, and ≥3 exercise sessions/week groups, respectively. The likelihood of prevalent CKD was lowest in participants allocated to the ≥3 sessions/week group (adjusted OR 0.49; 95% CI, 0.33-0.71; P<0.001). During a median follow-up of 5.0 years in the NHIS cohort, incident CKD occurred in 1,047 (9.7/1,000 person-years), 188 (7.3/1,000 person-years), and 478 (7.4/1,000 person-years) participants in the 0, 1-2, and ≥3 sessions/week groups, respectively. The risk of incident CKD was lowest in participants allocated to the ≥3 sessions/week group (adjusted HR 0.85; 95% CI, 0.76-0.95; P=0.004).