Role of Physical Activity, Diet and Lifestyle-Associated Determinants in the Clinical Management and Progression of Chronic Kidney Disease

Chronic kidney disease (CKD) is a major global health burden associated with increased morbidity, mortality, and reduced quality of life. In addition to pharmacological treatment, lifestyle-related factors such as physical activity, dietary habits, smoking, alcohol consumption, sleep quality and psychosocial health play a crucial role in the clinical management and progression of CKD. This review aimed to summarize current evidence regarding the impact of physical activity, diet and lifestyle-associated determinants on CKD progression and patient outcomes. A narrative review of recent clinical guidelines, observational studies, and interventional research was conducted, focusing on nutritional management, plant-based dietary patterns, obesity, mental health, sleep disturbances, smoking, alcohol use and multidisciplinary care approaches in CKD. The evidence indicates that regular physical activity improves cardiovascular and metabolic health, enhances functional capacity and can slow renal function decline. Dietary interventions, particularly plant-dominant patterns and structured approaches such as DASH and Mediterranean diets, are associated with improved blood pressure control, reduced proteinuria and better cardiometabolic outcomes. Key nutritional factors, including protein, sodium, potassium, phosphorus and fiber intake, play critical roles in disease progression and require individualized management. Additional lifestyle factors such as smoking cessation, weight management, sleep quality and mental health support further contribute to improved outcomes. Multidisciplinary care and patient education are essential for effective long-term management. Integrating lifestyle modification with standard medical therapy should therefore be considered a key component of comprehensive CKD care.