• Martens Remy J H RJH 0000-0003-4632-6412 Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. , Julianne D van der Berg, Stehouwer Coen D A CDA Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. , Ronald M A Henry, Hans Bosma, Pieter C Dagnelie, van Dongen Martien C J M MCJM CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands. , Eussen Simone J P M SJPM CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands. , Miranda T Schram, Simone J S Sep, Carla J H van der Kallen, Nicolaas C Schaper, Savelberg Hans H C M HHCM NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands. , Frank M van der Sande, Abraham A Kroon, Jeroen P Kooman, and Annemarie Koster.
• Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
• Plos One. 2018 Jan 1; 13 (4): e0195306.

BackgroundChronic kidney disease, which is defined as having a reduced kidney function (estimated glomerular filtration rate (eGFR)) and/or signs of kidney damage (albuminuria), is highly prevalent in Western society and is associated with adverse health outcomes, such as cardiovascular disease. This warrants a search for risk factors of lower eGFR and higher albuminuria. Physical activity and sedentary behavior may be such risk factors.ObjectiveTo examine associations of physical activity (total, high, low), sedentary time and sedentary behavior patterns (breaks, prolonged bouts, average bout duration) with eGFR and albuminuria.MethodsWe examined these associations in 2,258 participants of the Maastricht Study (average age 60.1±8.1 years; 51.3% men), who wore an accelerometer 24h/day on 7 consecutive days. Associations with continuous eGFR and categories of urinary albumin excretion (UAE; <15 [reference category], 15-<30, ≥30 mg/24h) were evaluated with linear regression analyses and multinomial logistic regression analyses, respectively.ResultsAfter adjustment for potential confounders, each extra hour of total physical activity was associated with a more favorable kidney function (betaeGFR = 2.30 (95%CI = 1.46; 3.14)), whereas each extra hour of sedentary behavior was associated with a more adverse kidney function (betaeGFR = -0.71 (-1.08; -0.35)). Also, compared to individuals with the lowest levels of total physical activity, individuals with the highest levels had less kidney damage (OR15-<30mg/24h = 0.63 (0.41; 0.96), OR≥30mg/24h = 0.84 (0.53; 1.35). An extra hour of sedentary behavior was associated with more kidney damage (OR15-<30 mg/24h = 1.11 (1.01; 1.22), OR≥30 mg/24h = 1.10 (0.99; 1.22)). Further, a highly sedentary pattern was associated with a more adverse kidney function, but no association was seen with kidney damage.ConclusionsPhysical activity and sedentary behavior were associated with kidney function and kidney damage. Additionally, sedentary behavior patterns were associated with kidney function. Causal studies are required to examine whether this indeed implicates that prevention strategies should focus not only on increasing physical activity, but on reducing sedentary behavior as well.

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