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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 
 DIABETES & METABOLISM, Vol.48(5) : 101362, 2022-09 
Journal Title
Issue Date
Cohort Studies ; Cross-Sectional Studies ; Glomerular Filtration Rate ; Humans ; Non-alcoholic Fatty Liver Disease* / complications ; Non-alcoholic Fatty Liver Disease* / epidemiology ; Nutrition Surveys ; Renal Insufficiency, Chronic* / complications ; Renal Insufficiency, Chronic* / epidemiology ; Renal Insufficiency, Chronic* / prevention & control ; Risk Factors
Chronic kidney disease ; Exercise ; Lifestyle ; Nonalcoholic fatty liver disease ; Sedentary
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hee Byung(고희병)
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Kim, Hyung Woo(김형우) ORCID logo https://orcid.org/0000-0002-6305-452X
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Jung, Chan-Young(정찬영) ORCID logo https://orcid.org/0000-0002-2893-9576
Joo, Young Su(주영수) ORCID logo https://orcid.org/0000-0002-7890-0928
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