Racial differences in associations of physical activity with chronic kidney disease and end-stage renal disease in American adults: the REasons for Geographic and Racial Differences in Stroke (REGARDS) study Public

Abstract

Background Physical inactivity is a risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). We investigated whether there were racial disparities in the associations of physical activity with CKD and ESRD.

Methods We analyzed data from 30,239 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who had estimated GFR (eGFR) and urinary albumin-to-creatinine ratio (ACR) measured and physical activity level (poor, intermediate, or ideal) reported at baseline. We identified incident ESRD using linked data from the United States Renal Data System. We fitted multivariable logistic models and Cox proportional hazard models to estimate ORs of CKD and HRs of ESRD for physical activity levels among African Americans and whites.

Results At baseline, African Americans were more likely to be physically inactive than whites (37.7% and 32.1%, respectively). The incidence rates of ESRD among African Americans and whites were 385 and 79 cases per 100,000 person-years, respectively. Among participants who were inactive relative to those with ideal physical activity, African Americans were less likely than whites to have reduced kidney function (eGFR < 60/ mL/ min/ 1.73 m²) (ORs = 1.52 and 1.62, 95% CI: 1.30 - 1.77 and 1.42 - 1.84, respectively) and albuminuria (ACR ≥ 30 mg/g) (ORs = 1.26 and 1.31, 95% CI: 1.11 - 1.43 and 1.16 - 1.48, respectively), but more likely than whites to develop ESRD (HRs = 2.12 and 1.50, 95% CI = 1.52 - 2.95 and 0.88 - 2.57, respectively). The associations of physical activity with CKD and ESRD were not modified by race (Pinteraction > 0.05).

Conclusion These results suggest that lower physical activity level may be associated with higher prevalence of CKD among African Americans and whites, and higher risk for ESRD among African Americans. The associations of physical activity with CKD and ESRD may not be modified by race.

Table of Contents

1. Background/Literature review. 1

2. Methods. 10

3. Results. 14

4. Discussion. 18

5. References. 21

6. Tables

a. Table 1. 29

b. Table 2. 30

c. Table 3. 31

7. Figures

a. Figure 1. 32

b. Figure 2. 32

c. Figure 3. 33

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Mot-clé	end-stage renal disease chronic kidney disease albuminuria race physical activity
Committee Chair / Thesis Advisor	McClellan, William, Emory University

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