Abstract Background Patients with chronic kidney disease (CKD) are at high risk of progression to end stage renal disease and cardiovascular events. Physical activity may reduce these risks by improving metabolic health. We tested associations of physical activity with central components of metabolic health among people with moderate-severe non-diabetic CKD. Methods We performed a cross-sectional study of 47 people with CKD (estimated GFR 0.3). Conclusions Greater physical activity is associated with multiple manifestations of metabolic health among people with moderate-severe CKD.