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Exercise reduces risk of kidney disease in patients with type 2 diabetes

Exercise reduces risk of kidney disease in patients with type 2 diabetes

Regular bouts of moderate to vigorous activity can protect patients with type 2 diabetes from developing kidney disease, a research study has found.

Overweight and obese people with type 2 diabetes who undertook moderate to vigorous physical activity every week were significantly less likely to progress to chronic kidney disease than those who undertook minimal physical activity.

Increasing cumulative exercise by just over an hour a week is linked to a 33 per cent reduction in risk of renal disease. The researchers showed that the increase in physical activity is just as effective whether the extra exercise is undertaken in short bursts of less than ten minutes or for long periods of ten minutes and over.

The findings, published in the British Journal of Sports Medicine, show that being physically active is one of the most effective ways to prevent kidney disease in people with type 2 diabetes and can help patients unable or unwilling to engage in physical activity for over ten minutes.

Diabetes accounts for 30 to 50 per cent of chronic kidney disease cases globally, making it the leading cause of renal disease. Patients who have diabetes and chronic kidney disease have a ten-fold higher risk of death from any cause compared with those who have diabetes alone.

To determine whether there was an association between physical activity and chronic kidney disease risk in patients with type 2 diabetes, the researchers undertook a secondary analysis of an activity tracker study, which was part of the US Look AHEAD trial. The study involved 1,746 participants, with an average age of 58.

The participants were monitored for moderate to vigorous levels of physical activity and the extent of chronic kidney disease at the start of the study and again at one, four and eight years later. Chronic kidney disease was defined as a deterioration of at least 30 per cent in the estimated glomerular filtration rate, the rate at which kidneys remove waste and extra water from the blood to make urine (less than 60 ml/min).

On average, participants undertook 329 minutes of moderate to vigorous physical activity every week. Over 80 per cent of this was accumulated in periods of less than ten minutes, with the remaining 12.5 per cent in periods of more than ten minutes. Over the duration of the study, around one in three of the participants developed chronic kidney disease.

The participants who undertook the most moderate to vigorous physical activity, between 329 to 469 mins per week, were significantly less likely to progress to chronic kidney disease than those who did the least (under 220 mins).

The researchers found that for every 100 minutes of moderate to vigorous activity, there was a nine per cent lower risk of developing chronic kidney disease. This increased to 19 per cent if the exercise sessions lasted for at least ten minutes.

Participants who increased their weekly exercise tally by 63 minutes over the first four years of the study had a 33 per cent lower risk of kidney disease than those with the most significant decrease of minutes per week. The improvement was seen whether the physical activity sessions were greater than or less than ten minutes.

The researchers stated: ‘These findings are consistent with evidence that regular [physical activity] has direct anti-inflammatory effects, and can promote glycaemic control, improve insulin sensitivity, blood pressure, lipid profiles and other metabolic and cardiovascular risk factors, all of which are associated with renal function.’

The researchers suggest that all patients with diabetes should be encouraged to engage in as much exercise intensity as they can tolerate to maximise the benefits. Just over an hour a day of walking, cycling, jogging, or swimming could help overweight and obese adults with type 2 diabetes reduce their risk of progression to chronic kidney disease.


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