Washington DC VA Medical Center

Exercise Physiologist Dr. Peter Kokkinos

In the article, “Exercise Capacity and Risk of Chronic Kidney Disease in US Veterans: A Cohort Study”, published in the April, 2015 issue of Mayo Clinic Proceedings, researchers have found that higher aerobic fitness levels lower the risk of developing chronic kidney disease (CKD).

The study, led by Washington DC VA Medical Center’s exercise physiologist, Peter Kokkinos, PhD, and the Chief of Medical Service, Charles Faselis, MD, included 5,812 middle-aged male Veterans from the medical center who were CKD-free prior to entering the study.

During a median follow-up period of 7.9 years, 1,000 Veterans had developed CKD.  The CKD risk was 22% lower for every 1-MET (metabolic equivalent) increase in exercise capacity. The average exercise capacity necessary to realize these health benefits was just over 6.5 METs. This is good news, as this level of fitness is easily achievable by many middle-aged and older adults who participate in daily exercise such as brisk walking.

When considering fitness categories, CKD risk decreased progressively as fitness status increased. Specifically, when compared to the Least-Fit individuals, the risk of developing CKD was 13% 45% and 58% lower for individuals in the Low-Fit; Moderate and High-Fit categories, respectively. Thus, exercise interventions for individuals at risk for CKD and those with preclinical CKD may be implemented to prevent or at least attenuate the rate of developing CKD.

Moderate intensity exercises are effective in improving aerobic fitness regardless of age or comorbidities. According to Dr. Kokkinos, brisk walking is the safest, most effective and inexpensive way to increase fitness and improve health. He recommends individuals start slowly, even as low as ten minutes per day and add one to two minutes to their sessions each week. The goal is to accumulate a total of 150-200 minutes of aerobic activity each week.

It is important to note that physical activity is associated with some risk of injury and even death, especially for sedentary individuals. However, Dr. Kokkinos warns “The risk of physical inactivity is far greater than that of physical activity”. To reduce the risk even more, he recommends individuals consult their physician prior to engaging in any exercise.

The researchers’ next project is to assess if exercise can reverse or at least attenuate the deterioration of kidney function in patients with CKD.

For more information about Washington DC VA Medical Center’s research program, please contact the Office of Public Affairs, 202-745-4037.

Link to abstract: http://www.mayoclinicproceedings.org/article/S0025-6196(15)00074-9/abstract