Background: Physical activity has been shown to reduce chronic kidney disease/ end-stage renal disease. Much of its mechanism was attributed to the reduction of risk factors associated with CKD. The role of “resting heart rate (RHR)” in its association with CKD/ESRD with physical activity involved has never been explored. Methods: MJ cohort, N=543,667 adults, was recruited from participants from a private medical screening program across Taiwan (1996-2017). Each participant had data on physical activity (5 categories of MET-h/w), CKD (5 stages by eGFR and proteinuria) and RHR (10 beats/min increment from 40 based on EKD reading). Heart rate paradox connotes “rapid heart rate by vigorous exercise is required to achieve a healthier state of slower heart rate at rest”. Hazard ratios were calculated by Cox model. Some participants, active or inactive, made second visits offering data on changing RHR after engaging in physical activity. Results: A 3-way associated risks were established among physical activity, RHR and CKD/ESRD on this cohort, indicating: (1) Active individuals had less CKD: 11%, 7% and 12% less for CKD, proteinuria and ESRD, respectively. (2) Faster RHR had more CKD/ESRD: Risk increased by 14% /10 beat/min increase and by 24% increase comparing>= 80/min with 60-69/min.(3) Active individuals had slower RHR: 6 beats/min difference with active and 14% less all-cause mortality. Becoming active at second visit 1-2 years later from initially inactive participants with RHR at 80-89/min (N=6269), 2/3 of them slowed RHR down to <80/min, lowered mortality, fewer CKD and gained 4 years in life expectancy. Conclusions: We found slowing down RHR as an important mechanism for our observation of the ability of physical activity to reduce CKD/ESRD. CKD had faster RHR and, with vigorous exercise, “heart rate paradox” reduced CKD when RHR was reduced
Date:
2022-11
Relation:
Journal of the American Society of Nephrology. 2022 Nov;33(11S):952.
