Lifestyle Factors in Chronic Kidney Disease Management

Chronic kidney disease (CKD) represents a growing global health challenge, driven by ageing populations and the rising prevalence of diabetes and hypertension. Beyond pharmacotherapy, lifestyle modification has emerged as a cornerstone of CKD management, with strong evidence indicating that diet, physical activity, body weight, smoking and alcohol habits, and sedentary behaviour interact to influence disease onset and progression. Regular moderate‐to‐vigorous physical activity has been shown to preserve glomerular filtration rate and reduce proteinuria, while prolonged sedentary periods may exacerbate renal decline. Nutritional strategies—such as moderate protein restriction, reduced sodium intake, adoption of plant‐dominant diets and careful fluid management—help to control blood pressure and attenuate uraemic toxin accumulation. Weight optimisation reduces glomerular hyperfiltration and cardiovascular risk, and smoking cessation alleviates endothelial dysfunction and oxidative stress, both of which contribute to renal injury. Alcohol consumption exhibits a dose-dependent relationship with CKD risk, and counselling on safe limits is integral to holistic care. Lifestyle interventions also address comorbidities, enhance quality of life and reduce healthcare costs. Implementation requires a patient-centred, multidisciplinary approach, leveraging behavioural support and digital health tools to tailor recommendations and sustain long-term adherence. Despite challenges in translation, the synergy of dietary and activity-based measures offers a practical route to slow CKD progression and improve outcomes across diverse populations.

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Technical terms

Albuminuria: presence of albumin in the urine, indicating increased glomerular permeability and early kidney damage.

Estimated glomerular filtration rate (eGFR): an index of renal function calculated from serum biomarkers to estimate blood filtration by the kidneys.

Isotemporal substitution: a statistical method that models health effects when time spent in one activity (e.g. sedentary behaviour) is reallocated to another (e.g. physical activity).

Moderate-to-vigorous physical activity (MVPA): exercise of sufficient intensity to elevate heart rate and oxygen consumption, typically brisk walking or more strenuous pursuits.

References

1. Association of domain-specific physical activity with albuminuria among prediabetes and diabetes: a large cross-sectional study. Journal of Translational Medicine (2024).
2. Amount and pattern of physical activity and sedentary behavior are associated with kidney function and kidney damage: The Maastricht Study. PLOS ONE (2018).
3. Sedentary behaviour, physical activity, and renal function in older adults: isotemporal substitution modelling. BMC Nephrology (2020).