Original research| Volume 8, ISSUE 4, P315-321, December 2014

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Physical activity is associated with decreased incidence of chronic kidney disease in type 2 diabetes patients: A retrospective cohort study in Taiwan

  • Hsing-Chun Lin
    Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    School of Nutrition, Chung Shan Medical University, Taichung, Taiwan

    Department of Nutrition, Chung Shan Medical University Hospital, Taichung, Taiwan
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  • Chiung-Huei Peng
    Division of Basic Medical Science, Hungkuang University, Taichung, Taiwan
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  • Jeng-Yuan Chiou
    Corresponding author.
    The School of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan
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  • Chien-Ning Huang
    Corresponding author at: No. 110, Sec. 1, Jianguo North Road, South Dist., Taichung City 40201, Taiwan. Tel.: +886 4 24739595x34116; fax: +886 4 24739220.
    Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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      To assess the effect of physical activity in patients with type 2 diabetes mellitus on prevention of diabetes with chronic kidney disease.


      This is a cohort study on stratified selected subjects in Taiwan from 2004/01/01 to 2005/12/31. Demographic data, lifestyle factors and clinical characteristics were analyzed for an association with the occurrence of chronic kidney disease. Applicable analysis weights, Stata 11.0, were applied to adjust the design variables for clustering and stratification.


      During the two year study period, the univariate Cox proportional hazards model showed significant associations of age, physical activity, and the Charlson comorbidity index (CCI) with chronic kidney disease. Physical activity had a beneficial effect in diabetic subjects with chronic kidney disease (HR: 0.31, p < 0.01). Older age and a CCI greater than 2 were both harmful in diabetic subjects with chronic kidney disease (1.06 and 3.44, respectively). The results of a multivariate Cox proportional hazards evaluation model were similar to those of a univariate evaluation model, except that CCI was not significantly different. Moreover, medications for hypertension of diabetic subjects created an increased risk of chronic kidney disease (HR: 5.85 and 3.74, respectively), indicating that the presence of hypertension is a strong risk factor for the progression of chronic kidney disease.


      In this study, physical activity was not only a healthful lifestyle factor but also a treatment to decrease incidence of chronic kidney disease in diabetic patients.


      CCI (Charlson comorbidity index), CHF (chronic heart failure), CKD (chronic kidney disease), CVD (cardiovascular disease), ESRD (end-stage renal disease), UAE (urinary albumin excretion)


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