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Abstract: FR-PO953

Association Between Physical Activity and Renal Outcomes in Patients with CKD G3b-5: A Result from a Japanese Cohort Study, the REACH-J

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Hoshino, Junichi, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Tsunoda, Ryoya, Tsukuba Daigaku, Tsukuba, Ibaraki, Japan
  • Kai, Hirayasu, Tsukuba Daigaku, Tsukuba, Ibaraki, Japan
  • Saito, Chie, Tsukuba Daigaku, Tsukuba, Ibaraki, Japan
  • Okada, Hirokazu, Saitama Ika Daigaku, Iruma-gun, Saitama, Japan
  • Narita, Ichiei, Niigata Daigaku, Niigata, Niigata, Japan
  • Wada, Takashi, Kanazawa Daigaku, Kanazawa, Ishikawa, Japan
  • Maruyama, Shoichi, Nagoya Daigaku, Nagoya, Aichi, Japan
  • Yamagata, Kunihiro, Tsukuba Daigaku, Tsukuba, Ibaraki, Japan

Group or Team Name

  • The REACH-J.

Association between physical activity and renal outcome in patients with chronic kidney disease (CKD) has remained largely unexamined.


We recruited 2,249 advanced CKD patients (eGFR<45 ml/min/1.73m2) receiving nephrologist care from a national sample of 31 facilities throughout Japan, randomly selected with stratification by region and facility size, aligned with the international CKD Outcomes and Practice Patterns Study (CKDopps). Association between baseline physical activity levels (active or inactive, from Rapid Assessment of Physical Activity (RAPA) surveys) and 5-year renal outcomes (40% eGFR decline, end-stage kidney disease, or death) were analyzed.


Of 1808 eligible CKD patients with RAPA assessment, 407 patients with diabetic kidney disease (DKD) and 1401 patients without diabetes (non-DKD) were enrolled. Of them, 1237 patient (68% of total, 66% of DKD and 69% of non-DKD) were categorized “active” (often active or very active by RAPA score), and others were categorized “inactive”. The mean ages and eGFRs in “active” and “inactive” patients were 68.5±12.5 and 70.8±11.7 years, and 24.1±10.4 and 22.1±10.4 mL/min/1.73m2, respectively.
Crude rates for CKD progression per 100 person-years in “active” and “inactive” patients were 19.4 and 22.1 events in DKD, and 12.1 and 13.7 events in non-DKD, respectively. In addition, crude rates for mortality in those patients were 3.9 and 4.8 events in DKD, and 1.8 and 3.8 events in non-DKD, respectively. Composite CKD progression and mortality were considerably lower at higher physical activity in both DKD and non-DKD patients, with hazard ratios of 0.84 (0.66, 1.08) and 0.80 (0.69, 0.93), respectively.


This multicenter study suggested the association between higher physical activity and lower CKD progression and better survival in both DKD and non-DKD patients. These findings may support future studies understanding impact of physical activity for better renal outcomes in patients with CKD stage G3b-5.