Modifiable Lifestyle Behaviors and CKD Progression: A Narrative Review

Jun 20, 2022Kidney360

How Lifestyle Habits May Affect the Progression of Chronic Kidney Disease

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Current guidelines recommend patients with chronic kidney disease (CKD) engage in healthy lifestyle behaviors to potentially improve outcomes.

Limited studies explore the impact of lifestyle factors on the progression of CKD among patients with established CKD.
Engagement in healthy behaviors such as diet, physical activity, and weight management may be correlated with slower CKD progression, as indicated by measures like decline in glomerular filtration rate (GFR).
Many existing studies suffer from short follow-up periods and small sample sizes, complicating the ability to draw definitive conclusions.
The relationship between lifestyle factors and CKD progression is complicated by varying classifications of behaviors and progression metrics in the literature.
Further research is needed to identify effective methods to assess lifestyle behaviors and their combined effects on CKD outcomes.

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Living a healthy lifestyle is one of the safest and most cost-effective ways to improve one's quality of life and prevent and/or manage chronic disease. As such, current CKD management guidelines recommend that patients adhere to a healthy diet, perform ≥150 minutes per week of physical activity, manage their body weight, abstain from tobacco use, and limit alcohol. However, there are limited studies that investigate the relationship between these lifestyle factors and the progression of CKD among people with established CKD. In this narrative review, we examine the reported frequencies of health lifestyle behavior engagement among individuals with non-dialysis-dependent CKD and the existing literature that examines the influences of diet, physical activity, weight management, alcohol consumption, and tobacco use on the progression of CKD, as measured by decline in GFR, incident ESKD, or elevated proteinuria or albuminuria in individuals with CKD. Many of the available studies are limited by length of follow-up and small sample sizes, and meta-analyses were limited because the studies were sparse and had heterogeneous classifications of behaviors and/or referent groups and of CKD progression. Further research should be done to determine optimal methods to assess behaviors to better understand the levels at which healthy lifestyle behaviors are needed to slow CKD progression, to investigate the effect of combining multiple lifestyle behaviors on important clinical outcomes in CKD, and to develop effective techniques for behavior change. Despite the lack of evidence of efficacy from large trials on the ability of lifestyle behaviors to slow CKD progression, maintaining a healthy lifestyle remains a cornerstone of CKD management given the undisputed benefits of healthy lifestyle behaviors on cardiovascular health, BP control, and survival.

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Modifiable Lifestyle Behaviors and CKD Progression: A Narrative Review

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