Exercise reduces the risk of chronic kidney disease in individuals with nonalcoholic fatty liver disease: A nationwide cohort study

Chan Young Jung; Ho Soo Chun; Minjong Lee; Hee Byung Koh; Keun Hyung Park; Young Su Joo; Hyung Woo Kim; Sang Hoon Ahn; Jung Tak Park; Seung Up Kim

doi:10.1016/j.diabet.2022.101362

Exercise reduces the risk of chronic kidney disease in individuals with nonalcoholic fatty liver disease: A nationwide cohort study

Chan Young Jung, Ho Soo Chun, Minjong Lee, Hee Byung Koh, Keun Hyung Park, Young Su Joo, Hyung Woo Kim, Sang Hoon Ahn, Jung Tak Park, Seung Up Kim

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

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 7275 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). Conclusions: Exercise was significantly associated with a reduced risk of both prevalent and incident CKD in individuals with NAFLD.

Original language	English
Article number	101362
Journal	Diabetes and Metabolism
Volume	48
Issue number	5
DOIs	https://doi.org/10.1016/j.diabet.2022.101362
State	Published - Sep 2022

Bibliographical note

Funding Information:
Seung Up Kim has served as an advisory committee member Gilead Sciences, Bayer, Eisai, and Novo Nordisk. He is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, Eisai, Otsuka, and Bristol-Myers Squibb. He has also received a research grant from Abbive and Bristol-Myers Squibb. The other authors declare that they have no competing interests.

Publisher Copyright:
© 2022 Elsevier Masson SAS

Keywords

Chronic kidney disease
Exercise
Lifestyle
Nonalcoholic fatty liver disease
Sedentary

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.diabet.2022.101362

Cite this

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title = "Exercise reduces the risk of chronic kidney disease in individuals with nonalcoholic fatty liver disease: A nationwide cohort study",

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 7275 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). Conclusions: Exercise was significantly associated with a reduced risk of both prevalent and incident CKD in individuals with NAFLD.",

keywords = "Chronic kidney disease, Exercise, Lifestyle, Nonalcoholic fatty liver disease, Sedentary",

author = "Jung, {Chan Young} and Chun, {Ho Soo} and Minjong Lee and Koh, {Hee Byung} and Park, {Keun Hyung} and Joo, {Young Su} and Kim, {Hyung Woo} and Ahn, {Sang Hoon} and Park, {Jung Tak} and Kim, {Seung Up}",

note = "Funding Information: Seung Up Kim has served as an advisory committee member Gilead Sciences, Bayer, Eisai, and Novo Nordisk. He is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, Eisai, Otsuka, and Bristol-Myers Squibb. He has also received a research grant from Abbive and Bristol-Myers Squibb. The other authors declare that they have no competing interests. Publisher Copyright: {\textcopyright} 2022 Elsevier Masson SAS",

year = "2022",

month = sep,

doi = "10.1016/j.diabet.2022.101362",

language = "English",

volume = "48",

journal = "Diabetes and Metabolism",

issn = "1262-3636",

publisher = "Elsevier Masson s.r.l.",

number = "5",

}

TY - JOUR

T1 - Exercise reduces the risk of chronic kidney disease in individuals with nonalcoholic fatty liver disease

T2 - A nationwide cohort study

AU - Jung, Chan Young

AU - Chun, Ho Soo

AU - Lee, Minjong

AU - Koh, Hee Byung

AU - Park, Keun Hyung

AU - Joo, Young Su

AU - Kim, Hyung Woo

AU - Ahn, Sang Hoon

AU - Park, Jung Tak

AU - Kim, Seung Up

N1 - Funding Information: Seung Up Kim has served as an advisory committee member Gilead Sciences, Bayer, Eisai, and Novo Nordisk. He is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, Eisai, Otsuka, and Bristol-Myers Squibb. He has also received a research grant from Abbive and Bristol-Myers Squibb. The other authors declare that they have no competing interests. Publisher Copyright: © 2022 Elsevier Masson SAS

PY - 2022/9

Y1 - 2022/9

N2 - 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 7275 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). Conclusions: Exercise was significantly associated with a reduced risk of both prevalent and incident CKD in individuals with NAFLD.

AB - 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 7275 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). Conclusions: Exercise was significantly associated with a reduced risk of both prevalent and incident CKD in individuals with NAFLD.

KW - Chronic kidney disease

KW - Exercise

KW - Lifestyle

KW - Nonalcoholic fatty liver disease

KW - Sedentary

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DO - 10.1016/j.diabet.2022.101362

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JO - Diabetes and Metabolism

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ER -

Exercise reduces the risk of chronic kidney disease in individuals with nonalcoholic fatty liver disease: A nationwide cohort study

Abstract

Bibliographical note

Keywords

UN SDGs

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