| Title: | The Mediating Effect of 24-Hour Movement Behaviors on Mortality Risk in Chronic Kidney Disease: A Compositional Mediation and Life Expectancy Analysis. |
| Journal: | Journal of Physical Activity and Health |
| Published: | 17 Oct 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41110464/ |
| DOI: | https://doi.org/10.1123/jpah.2025-0467 |
Publication 16716
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Abstract
BACKGROUND: To investigate the mediating effect of 24-hour movement behaviors on the relationship between chronic kidney disease (CKD) and mortality risk; additionally, to assess the health benefits of reallocating sedentary behavior (SB) with physical activity.</p>
METHODS: This prospective cohort study included 88,795 participants (aged 43-78) from the UK Biobank with valid accelerometer data. A compositional mediation model assessed whether 24-hour movement behaviors mediate the CKD-mortality association. A flexible parametric hazards model was used to estimate life expectancy under various reallocation scenarios of 24-hour movement behaviors.</p>
RESULTS: During a median follow-up of 8.10 years, 3673 participants met CKD criteria, and 3117 died. CKD increased all-cause mortality risk through greater SB and reduced light-intensity physical activity and moderate to vigorous physical activity (MVPA; hazard ratios = 1.040; 95% confidence interval, 1.030-1.050). Reallocating 20 minutes per day of SB to MVPA increased life expectancy by 1.70 years at age 45 (95% confidence interval, 0.51-4.34).</p>
CONCLUSIONS: Twenty four-hour movement behaviors partially mediate mortality risk in CKD, with MVPA showing the strongest protective effect. Interventions that reduce SB and increase MVPA can improve survival in CKD populations.</p>
10 Authors
- Zhehao Wang
- Yiting Huang
- Jing Xu
- Wayne R Lawrence
- Jiade Chen
- Yutai Cai
- Tao Zhang
- Qiaoman Mo
- Yanhui Gao
- Ziqiang Lin
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