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Nephrology (Carlton). 2015 Feb;20(2):61-7. doi: 10.1111/nep.12355.

Physical activity and risk of end-stage kidney disease in the Singapore Chinese Health Study.

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Laboratory of Cardiovascular and Renal Risk Reduction, Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore.



To explore the relationship between physical activity and risk of end-stage kidney disease (ESKD).


We analysed data on a prospective cohort of 59,552 Chinese adults aged 45-74 years enrolled in the Singapore Chinese Health Study. Information on physical activity was collected with a structured questionnaire. Physically active individuals were defined as those who engaged in any moderate activities for 2 h or more per week and any strenuous activities 30 min or more per week. Incident ESKD was identified via record linkage with the Singapore Registry of Birth and Death and Singapore Renal Registry. Cox proportional hazards regression method was used for analysis for risk of incident ESKD alone or ESKD plus death associated with physical activity.


During a median follow-up of 15.3 years, a total of 642 incident ESKD occurred, and 9808 study participants died. A 24% lower adjusted risk of ESKD (hazard ratio: 0.76; 95% confidence interval: 0.62-0.93) was associated with moderate or strenuous physical activities compared with no regular physical activity. This association appeared to be dose dependent with the lowest risk for subjects at highest intensity of physical activity (P trend <0.003). Similar results were observed for risk of ESKD plus death.


Higher levels of physical activity are associated with lower risk of ESKD. Our findings highlight the role of physical activity for prevention of ESKD, which deserves further evaluation in intervention trials.


end-stage kidney disease; exercise; physical activity

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