Accelerometer-derived “weekend warrior” physical activity pattern and all-cause mortality in individuals with kidney stones: a prospective cohort study

Abstract

Background Kidney stone disease is a prevalent urological condition associated with significant metabolic comorbidities and increased mortality risk. While the “weekend warrior” (WW) physical activity pattern has been linked to reduced mortality in the general population, its impact on patients with kidney stones remains unclear. This study aimed to evaluate the association between accelerometer-derived WW physical activity pattern and all-cause mortality in individuals with kidney stones, and to identify the dose–response relationship and optimal activity thresholds. Methods We conducted a prospective cohort study using data from the UK Biobank. Participants with a history of kidney stones ( n = 1,348) were included. Physical activity was measured via wrist-worn accelerometers, categorizing participants into three groups: the regularly active pattern, the WW pattern, and the inactive group. The primary outcome was all-cause mortality. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographic, lifestyle, and clinical covariates. Restricted cubic splines (RCS) were employed to explore nonlinear associations. Results During a median follow-up of 15.24 years (interquartile range: 5.54–17.36 years), 101 participants died from all causes. Compared with inactive individuals, the WW pattern was associated with a 49% reduction in all-cause mortality (HR 0.51, 95% CI 0.32–0.81) after full adjustment, which was comparable to the benefit observed in regularly active individuals (HR 0.45, 95% CI 0.23–0.90). Dose–response analysis revealed an L-shaped association between total MVPA and all-cause mortality, with a saturation point identified at 183 min/week. Sensitivity analyses demonstrated that the survival benefit of the WW pattern disappeared when the threshold was increased to 230 min/week (HR 0.76, 95% CI 0.47–1.23), a finding consistent with recent high-threshold studies in other cohorts. Conclusion The accelerometer-derived WW activity pattern was associated with lower all-cause mortality among individuals with kidney stones, with an association comparable in magnitude to that observed for regular activity. The inverse association between total MVPA and mortality appeared to plateau at approximately 180 min/week; however, this value should not be interpreted as a definitive clinical threshold. These findings support the potential importance of achieving guideline-recommended MVPA, even when concentrated over 1–2 days, and warrant confirmation in prospective and interventional studies.