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  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Impact of exercise on all-cause and cardiovascular mortality in non-dialysis chronic kidney disease: the Japan specific health checkups (J-SHC) study

Hypertension Research volume 48, pages 2831–2840 (2025)Cite this article

Abstract

Exercise is well known to reduce the risk of cardiovascular diseases and mortality. However, studies in individuals with chronic kidney disease (CKD) are limited. This study used large population-based data to investigate the differences in the impact of exercise habits on all-cause and cardiovascular mortality between individuals with and without CKD. This study included participants from the Japan Specific Health Checkups (J-SHC) Study conducted between 2008 and 2014. The exposure of interest was self-reported daily exercise habits. The association between exercise habits and all-cause and cardiovascular mortality was examined using Cox regression analysis based on the CKD status. Of the 469,466 participants, 84,508 (18.0%) had CKD, and 39,343 (46.6%) exercised. During the median follow-up period of 44.0 months, 3932 (2.76/1000 person-years) and 1505 (5.09/1000 person-years) participants died in the non-CKD and CKD cohorts, respectively. Exercise habits were associated with a lower risk of all-cause mortality in the non-CKD and CKD cohorts, with adjusted hazard ratios and 95% confidence intervals of 0.80 (0.75–0.86) and 0.70 (0.63–0.78), respectively. The effect of exercise habits on mortality was greater in the CKD group (P for interaction = 0.02). Similar results were observed for cardiovascular mortality. Regular exercise was more strongly associated with decreased all-cause and cardiovascular mortality in individuals with CKD than in those without. Our study highlights the need for individuals with mild CKD to prioritize exercise habits over those without CKD.

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Acknowledgements

We acknowledge the contributions of the staff members who collected the data and instructed subjects on urinalysis at the screening centers in Yamagata, Fukushima, Ibaraki, Niigata, Osaka, Fukuoka, Miyazaki, and Okinawa. We want to thank Editage for the English language editing.

Funding

This work was supported by Health and Labor Sciences Research Grants for Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Risk Assessment by Specific Health Checkup from the Ministry of Health, Labor, and Welfare of Japan and a Grant-in-Aid for Research on Advanced Chronic Kidney Disease (REACH-J) and Practical Research Project for Renal Disease from the Japan Agency for Medical Research and Development (AMED).

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Authors and Affiliations

  1. Department of Nephrology, Nara Medical University, Nara, Japan

    Hikari Tasaki, Takaaki Kosugi, Masahiro Eriguchi, Takayuki Uemura, Hiroyuki Tamaki, Riri Furuyama, Masatoshi Nishimoto, Masaru Matsui, Ken-ichi Samejima & Kazuhiko Tsuruya

  2. Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan

    Hisako Yoshida

  3. Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Fukushima, Japan

    Kunitoshi Iseki, Koichi Asahi, Kunihiro Yamagata, Tsuneo Konta, Shouichi Fujimoto, Ichiei Narita, Masato Kasahara, Yugo Shibagaki, Toshiki Moriyama, Masahide Kondo, Tsuyoshi Watanabe & Kazuhiko Tsuruya

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  1. Hikari Tasaki
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  2. Takaaki Kosugi
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Contributions

Research idea and study design: HTas, TK, ME, TU, HTam, RF, MN, MM, KS, KT; data acquisition: HY, KI, CI, KA, KY, TK, SF, IN, MKa, YS, TM, MKo, TW, KT; data analysis/interpretation: HTas, TK, ME, KT; statistical analysis: HTas, TK, ME; supervision or mentorship: TK, ME, KT. Each author contributed important intellectual content during manuscript drafting or revision and accepted accountability for the overall work by ensuring that questions about the accuracy or integrity of any portion of the work were appropriately investigated and resolved.

Corresponding author

Correspondence to Masahiro Eriguchi.

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The authors declare no competing interests.

Ethics approval and consent to participate

All procedures involving human participants followed the ethical standards of the institutional research committee at which the study was conducted (Fukushima Medical University; IRB Approval Number #1485, #2771) and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was conducted following the Ethical Guidelines for Medical and Health Research Involving Human Subjects enacted by the Ministry of Health, Labor, and Welfare of Japan (http://www.mhlw.go.jp/file/06-Seisakujouhou-10600000-Daijinkanboukouseikagakuka/0000069410.pdf). According to these guidelines, investigators are not required to provide informed consent. Instead, we provided public information concerning the study on our website (http://www.fmu.ac.jp/univ/sangaku/data/koukai_2/2771.pdf). We ensured that there were opportunities for the research participants to refuse to use their personal information.

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Tasaki, H., Kosugi, T., Eriguchi, M. et al. Impact of exercise on all-cause and cardiovascular mortality in non-dialysis chronic kidney disease: the Japan specific health checkups (J-SHC) study. Hypertens Res 48, 2831–2840 (2025). https://doi.org/10.1038/s41440-025-02335-4

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