Moderate-intensity physical activity can slow decline in estimated glomerular filtration rate (eGFR) in sedentary older adults, a new study finds.

In the LIFE (Lifestyle Interventions and Independence For Elders) trial, investigators randomly assigned 1199 adults aged 70 to 89 years with mobility limitations to moderate-intensity physical activity or a health education workshop. Of the cohort, two-thirds had an eGFR less than 60 mL/min/1.73 m2, using cystatin C as the filtration marker. The activity component targeted 30 minutes of walking daily as well as 10 minutes of lower-extremity strength training, 10 minutes of balance training, and large-muscle flexibility exercises. This analysis was an ancillary study of the original trial.

Over 2 years, the physical activity and exercise intervention led to mean 0.96 mL/min/1.73 m2 less decline in eGFR compared with a health education workshop, Michael G. Shlipak, MD, MPH, of San Francisco VA Health Care System in California, and colleagues reported in JAMA Internal Medicine.


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Patients with the highest quartile of step count (3470 steps/d or more) had an approximately 2 mL/min/1.73 m2 slower decline in eGFR and, in a fully adjusted model, a significant 38% decreased odds of rapid decline compared with patients with the lowest quartile of step count (1567 steps/d or less).

Of the 1199 older adults, 29.1% experienced rapidly declining kidney function (defined as 6.7% per year), including 25.9% of the physical activity group and 32.2% of the health education group. The exercise intervention decreased the odds of rapid eGFR decline by a significant 21% compared with the control group. The effect appeared stronger among patients without cardiovascular disease.

“Clinicians should consider prescribing physical activity and moderate-intensity exercise for older adults to slow the rate of decline of kidney function,” according to Dr Shlipak’s team. They cautioned that exercise sessions need to be individualized.  

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Shlipak MG, Sheshadri A, Hsu FC, et al. Effect of structured, moderate exercise on kidney function decline in sedentary older adults: an ancillary analysis of the LIFE study randomized clinical trial. JAMA Intern Med. Published online May 2, 2022. doi:10.1001/jamainternmed.2022.1449

This article originally appeared on Renal and Urology News