Abstract

Aims: This study aimed to explore the relationship between PA domains, PA intensity, sedentary time, cardiometabolic factors, inflammatory markers, and risk of diabetic kidney disease (DKD) in adults. It also examined potential moderators of the relationship between PA and DKD including age, race and ethnicity. Materials and Methods: This cross-sectional study used data from the 2017–2018 National Health and Nutrition Examination Survey and included participants aged ≥ 18 years. The survey subjectively measured PA using the Global Physical Activity Questionnaire. After conducting multiple imputations to address missing data, we performed hierarchical logistic regression to identify factors significantly associated with DKD diagnosis and to examine moderating effects. Results: DKD prevalence was 13.32%. Non-Hispanic Black participants showed higher odds of DKD than non-Hispanic White participants. Age, waist circumference, systolic blood pressure, fasting glucose levels, haemoglobin A1C, high-sensitivity C-reactive protein, sedentary time, and occupation-related PA were significant predictors of DKD. Although age, race and ethnicity were significant predictors of DKD, we observed no moderating effects of these variables on the PA-DKD risk relationship. Conclusions: Cardiometabolic markers, inflammatory markers, and sedentary time significantly increase DKD risk, whereas occupation-related PA serves as a protective factor. This study highlights the need for interventions promoting a more active lifestyle in diabetic populations to mitigate their DKD risk.