CKD and Sedentary Time: Results From the Canadian Health Measures Survey

Rationale & Objective: Sedentary behavior and low physical activity are associated with incident diabetes, cardiovascular disease, and early mortality. Previous studies have examined associations between chronic kidney disease (CKD) and physical activity, but little is known about the role of sedentary time. Study Design: Cross-sectional national survey. Setting & Participants: A nationally representative sample of adults (n = 8,444) participating in the Canadian Health Measures Survey's (CHMS) activity monitoring component (2007-2013). Predictor: Estimated glomerular filtration rate (eGFR). Outcomes: Sedentary time (total sedentary minutes/total wear time) measured using triaxial accelerometry. Analytical Approach: Multivariable ordinal logistic regression for quartiles of sedentary time and linear regression for sedentary time measured on a continuous scale were performed in the entire study population and in the subgroup with CKD. Results: Mean proportion of sedentary time ranged from 58% (least sedentary quartile: Q1) to 81% (most sedentary quartile: Q4). Lower eGFR, older age, lower serum albumin level, higher blood pressure, cardiovascular disease, diabetes, and higher body mass index were independently associated with a higher proportion of sedentary time. Patients with eGFRs < 45 mL/min/1.73 m(2) had more than 4-fold higher likelihood of being sedentary (OR, 4.2; 95% CI, 2.5-7.3). Within the CKD subgroup, greater sedentary time was associated with diabetes (OR, 2.68; 95% CI, 1.56-4.59) and arthritis (OR, 2.32; 95% CI, 1.43-3.77) in adjusted analysis. Limitations: Cross-sectional design precluded evaluation of longitudinal outcomes and establishment of the causal nature of observed associations. Small sample of individuals with advanced CKD. Conclusions: In this cross-sectional survey, reduced eGFR was strongly and independently associated with greater sedentary time. This risk was further heightened by the presence of diabetes and arthritis. Studies to determine causes for sedentary behavior and assess the feasibility and value of interventions to reduce sedentary time in CKD are needed.