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Appropriate free-time physical activity (PA) is essential for overweight\/obese patients with chronic kidney disease, but specific guidelines are lacking. The present study was conducted to determine the association between PA and all-cause mortality in these patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data from 3,434 overweight\/obese adults with CKD from the 1999\u20132016 National Health and Nutrition Examination Surveys were analyzed. Associations between clinical\/laboratory findings and PA intensity (moderate and vigorous) were investigated. The all-cause mortality of patients in different PA categories were compared by Kaplan\u2013Meier analysis. Factors associated with all-cause mortality were determined using a Cox proportional hazards model. A restricted cubic spline was employed to obtain a more flexible and detailed representation of the relationship between PA intensity and all-cause mortality, with better predictive capability.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The Kaplan\u2013Meier analysis revealed that greater all-cause mortality was associated with &lt;\u200910\u00a0min\/week moderate\/vigorous PA (log-rank <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). A greater survival probability was associated with \u2265\u2009150\u00a0min\/week vigorous PA or 10\u2013149\u00a0min\/week moderate PA (log-rank <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Age, gender, vigorous PA, smoking status, alcohol consumption, diabetes status, eGFR, serum albumin level, uric acid level, and blood urea nitrogen level were identified as factors associated independently with mortality in the Cox proportional hazards analysis. The restricted cubic splines revealed that these relationships were non-linear (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Kaplan\u2013Meier analysis of data from patients who engaged in 10\u2013450\u00a0min\/week moderate\/vigorous PA revealed significant differences between the 0\u201374-min\/week and other vigorous PA groups (all log-rank <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Extended durations of vigorous PA are associated with reduced all-cause mortality in overweight\/obese patients with CKD. Clinicians should recommend vigorous free-time PA to these patients, and public health interventions should target this goal to maximize patient health.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12889-024-20498-6","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T14:03:01Z","timestamp":1730383381000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Exercise intensity and mortality in overweight and obese patients with chronic kidney disease: longitudinal analysis (1999\u20132016)"],"prefix":"10.1186","volume":"24","author":[{"given":"Chuyue","family":"Qian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengjun","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingda","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mindan","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,31]]},"reference":[{"key":"20498_CR1","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","volume":"395","author":"GBD Chronic Kidney Disease Collaboration","year":"2020","unstructured":"GBD Chronic Kidney Disease Collaboration. 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