title: Physical activity and risk of end-stage kidney disease in the Singapore Chinese Health Study.
abstract: OBJECTIVE
  To explore the relationship between physical activity and risk of end-stage kidney disease (ESKD).
  
  
  METHODS
  We analysed data on a prospective cohort of 59,552 Chinese adults aged 45-74 years enrolled in the Singapore Chinese Health Study. Information on physical activity was collected with a structured questionnaire. Physically active individuals were defined as those who engaged in any moderate activities for 2 h or more per week and any strenuous activities 30 min or more per week. Incident ESKD was identified via record linkage with the Singapore Registry of Birth and Death and Singapore Renal Registry. Cox proportional hazards regression method was used for analysis for risk of incident ESKD alone or ESKD plus death associated with physical activity.
  
  
  RESULTS
  During a median follow-up of 15.3 years, a total of 642 incident ESKD occurred, and 9808 study participants died. A 24% lower adjusted risk of ESKD (hazard ratio: 0.76; 95% confidence interval: 0.62-0.93) was associated with moderate or strenuous physical activities compared with no regular physical activity. This association appeared to be dose dependent with the lowest risk for subjects at highest intensity of physical activity (P trend <0.003). Similar results were observed for risk of ESKD plus death.
  
  
  CONCLUSIONS
  Higher levels of physical activity are associated with lower risk of ESKD. Our findings highlight the role of physical activity for prevention of ESKD, which deserves further evaluation in intervention trials.
authors.affiliation: Laboratory of Cardiovascular and Renal Risk Reduction, Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore.
authors.forename: Tazeen Hasan
authors.initials: TH
authors.lastname: Jafar
authors.forename: Aizhen
authors.initials: A
authors.lastname: Jin
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yuan
authors.forename: Khuan Yew
authors.initials: KY
authors.lastname: Chow
mesh_terms: D000368:Aged; D044466:Asian People; D002681:China / Q000208:ethnology; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D065840:Protective Factors; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D057185:Sedentary Behavior / Q000208:ethnology*; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: end-stage kidney disease; exercise; physical activity