Impact of high intensity physical activity compared to routine counseling on renal function decline in patients with type 2 diabetes at high risk for kidney disease - the ACTIDIANE randomized controlled trial - 05/06/26
, Stéphanie Ragot c, Lisa Durocher c, Edith Bigot-Corbel a, d, Laurence Kessler e, Igor Tauveron f, g, Tiphaine Vidal-Trecan h, i, Pierre Jean Saulnier c, Pierre Gourdy j, Myriam Moret k, Vincent Rigalleau l, Sophie Borot m, Pierre Henri Ducluzeau n, Cécile Ciangura o, Nicolas Paquot p, q, Anne Vambergue r, Nicolas Chevalier s, Claire Carette t, Arnaud Monier u, Philip Böhme v, w, Alfred Pernfornis x, Bruno Verges y, Pierre Morcel b, Jean François Gautier h, i, Jean-Michel Halimi z, Patrick Henry aa, Michel Marre i, ab, André Scheen q, Martine Duclos ac, Laurent Bosquet ad, Bertrand Cariou a, bfor the
ACTIDIANE study group
Highlights |
• | What was known: Diabetes is associated with chronic kidney disease (CKD).Compared to standard physical activity (PA), high-intensity PA is associated with a favorable impact for many outcomes: physical fitness, A1c, inflammation, blood pressure.Epidemiological studies suggest a favorable effect of PA for CKD, but PA intervention studies are scarce. |
• | This study adds: The ACTIDIANE study recruited patients with type 2 diabetes and rapid renal function decline.Compared to standard counseling on PA, high-intensity PA was associated with an improved physical fitness but only a non-significant difference in renal function decline. |
• | Potential impact: Comparison in PA trial must include a control arm with standard counseling on PAHigh-intensity PA may be associated with deleterious as well as beneficial effects on renal function decline. |
Abstract |
Background and hypothesis |
While physical activity (PA) is associated in observational studies with cardiovascular and renal protection few interventional studies have assessed its long-term effect on renal outcomes. This study is the first to specifically evaluate the impact of high-intensity PA on the slowing of renal function decline in type 2 diabetes (T2D) patients at high risk for kidney disease.
Methods |
ActiDiaNe is an open, randomized controlled trial involving patients with T2D (pT2D) and rapid renal function decline (eGFR slope < -5 ml/min/year over 6–24 months). Participants were randomized to high-intensity PA (HIPA) or standard PA counseling (STPA) for two years. The primary endpoint was the slope of decline in cystatin C-derived eGFR (cys-eGFR).
Results |
Across 21 centers, 178 patients were screened, 122 randomized, and 103 (29 women/74 men) analyzed for the primary endpoint (59 HIPA vs. 44 STPA). At baseline, mean age was 66 ± 8 years, median cys-eGFR was 54 ml/min/1.73m² (37; 65), and median eGFR decline was -9 ml/min/year (-12; -7). The primary endpoint showed a decline of -2.05 ml/min/year (95% CI: -3.46 to -0.64) in HIPA vs. -2.77 ml/min/year (95% CI: -4.40 to -1.14) in STPA ( P = 0.512). Cardiovascular events and deaths occurred in 10 (17%) HIPA vs. 6 (14%) STPA patients ( P = 0.646), with 3 deaths in HIPA (none of them protocol-related). Hypoglycemia was reported in 32 HIPA vs. 26 STPA patients ( P = 0.623).
Conclusion |
In pT2D with rapid renal function decline, HIPA did not significantly alter renal function decline compared to STPA.
Le texte complet de cet article est disponible en PDF.Keywords : Diabetes, Diabetic kidney disease, Physical activity, Randomized controlled trial, Rapid renal function decline
Plan
Vol 52 - N° 4
Article 101772- juillet 2026 Retour au numéro
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