There is limited information on the association between habitual physical activity (PA) and renal function.

To report the longitudinal association between self-reported habitual PA and measures of renal function in a large cohort in Taiwan.

A total of 199 421 participants (aged ≥20 years) were selected from a Taiwan cohort between 1996 and 2014. All participants underwent at least two standardised medical examinations between 1996 and 2014. Self-administrated questionnaires were used to collect information on habitual PA. We used a generalised linear mixed model to investigate the associations between habitual PA and yearly change in estimated glomerular filtration rate (eGFR). The Cox proportional hazard regression model was used to investigate the associations between habitual PA and incident chronic kidney disease (CKD).

Participants had a median follow-up duration of 4.2 years (0.2–18.9). The yearly mean (±SD) decrease in eGFR in participants with baseline very low-PA, low-PA, moderate-PA and high-PA was 0.46±1.01, 0.36±0.97, 0.30±0.94 and 0.27±0.91 mL/min/1.73 m², respectively. Relative to the participants with very low-PA, the coefficients of yearly eGFR change were −43.93 (95% CI −79.18 to −8.68), 35.20 (95% CI −2.56 to 72.96) and 53.56 (95% CI 10.42 to 96.70) µL/min/1.73 m², respectively, for the participants with low-PA, moderate-PA and high-PA, after controlling for a wide range of covariates. Relative to the very low-PA participants, those who had low-PA, moderate-PA and high-habitual PA had HRs of 0.93 (95% CI 0.88 to 0.98), 0.94 (95% CI 0.89 to 0.99) and 0.91 (95% CI 0.85 to 0.96) to develop CKD, respectively, after controlling for the covariates.

A higher level of habitual PA is associated with a smaller decrease in the level of eGFR and a lower risk of developing CKD.