Introduction: For chronic kidney disease (CKD) patients with or without
cardiovascular diseases, the associations between leisure-time physical activity
intensity (LTPA) and daily exercise time with mortality risk remain
unclear. Method: This study enrolled 3279 CKD patients from National
Health and Nutrition Examination Survey (NHANES) 2007–2014 survey. Patients were
grouped into different groups according to LTPA intensity (none, moderate,
vigorous) and duration (0 min, 0–30 min, 30–60 min, 60 min). We selected the
confounders based on their connections with the outcomes of interest or a change
in effect estimate of more than 10%. Multivariable-adjusted Cox proportional
hazards models were used to examine the associations between LTPA and mortality.
The three-knot cubic spline (10, 50, and 90%) was employed to investigate the
relationship between the dose of LTPA duration and all-cause death. Patients were
divided into different groups according to cardiovascular diseases (CVD).
Results: A total of 564 all-cause death were recorded in this study.
Multivariable Cox regression showed that moderate LTPA was associated with a
reduced risk of mortality by 38% (hazard ratio (HR): 0.62, 95% confidence
interval (CI): 0.44–0.88) in CKD patients, while vigorous LTPA did not have
evident survival benefits (HR: 0.91, 95% CI: 0.46–2.64). Subgroups analysis
demonstrated that those who engaged in moderate LTPA have a significantly lower
risk of mortality (HR: 0.67, 95% CI: 0.47–0.95) in patients without CVD, while
patients complicated with CVD did not benefit from the practice (HR: 0.61, 95%
CI: 0.37–1.02). Physical exercise for more than 30 minutes was associated with a
lower risk of mortality in general CKD patients (30–60 min: HR: 0.23, 95% CI:
0.09–0.58, 60 min: HR: 0.23, 95% CI: 0.08–0.63) and those without CVD
(30–60 min/d: HR: 0.32, 95% CI: 0.12–0.83, 60 min/d: HR: 0.20, 95% CI:
0.06–0.71); however, this positive outcome was not seen in patients complicated
with CVD (30–60 min/d: HR: 0.67, 95% CI: 0.11–4.04, 60 min/d: HR: 1.14,
95% CI: 0.14–9.11). Conclusions: Moderate LTPA for more than 30
minutes is associated with a reduced risk of mortality in general CKD patients
and those without CVD. However, LTPA did not reduce the risk of mortality in CKD
patients complicated with CVD.