The following is the summary of “Self-reported Physical Activity and Cardiovascular Events in Adults With CKD: Findings From the CRIC (Chronic Renal Insufficiency Cohort) Study” published in the December 2022 issue of Kidney diseases by Bruinius, et al.

Higher levels of physical activity are associated with lower risk of cardiovascular events and mortality in the general population, but this correlation has not been adequately examined in people with chronic kidney disease (CKD). Therefore, the correlation between self-reported exercise and outcomes in a cohort of people with CKD was studied.  Future-looking cohort study. The CRIC Study has 3,926 individuals with chronic kidney failure. Self-reported physical activity as measured by quartile of moderate-to-vigorous physical activity (MVPA) and meeting guideline-recommended level of physical activity was modified in Exposure Time (categorized as active, meeting guidelines; active, not meeting guidelines; or inactive).

The end results were atherothrombotic events (such as heart attack, stroke, and peripheral artery disease), incident heart failure, and all-cause and cardiovascular mortality. Cox regression with a proportional hazards model was used for the analysis. Those in the highest MVPA quartile were more likely to be younger, male, free of prevalent cardiovascular disease, and have a higher estimated glomerular filtration rate than those in the lowest MVPA quartile. Only 51% of adults were physically active enough, and 30% of the others were completely inactive. There were 772 atherosclerotic events, 848 heart failure events, 1,553 fatalities, and 420 cardiovascular deaths throughout the median 13.4-year follow-up period. Those in the highest quartile of MVPA had a decreased risk of atherosclerotic events (HR, 0.64 [95% CI, 0.51-0.79]), acute heart failure (HR, 0.71 [95% CI, 0.58-0.87]), and both all-cause and cardiovascular death (HRs of 0.54 [95% CI, 0.46-0.63] and 0.47 [95% CI, 0.35-0.64], respectively). 

Analyses that looked at the optimal amount of exercise yielded comparable results. A certain amount of misclassification is possible when people rely on their own reports of their physical activity levels. Significant implications for clinical practice and interventional study design may arise from the finding that CKD patients who reported higher levels of self-reported physical activity also had a lower risk of cardiovascular events and mortality.