LIFESTYLE MODIFICATION FOR PREVENTING THE PROGRESSION OF CKD

Chronic kidney disease (CKD) is a progressive and debilitating condition affecting more than 10% of the global population. This article highlights the lifestyle modifications, optimal control of hypertension (HTN) and diabetes mellitus (DM), and pharmacological therapies play critical roles in slowing CKD progression. Regular walking, weight reduction, adherence to a low-protein diet (LPD), the alternate Mediterranean (aMed) diet, and the Alternative Healthy Eating Index (AHEI)-2010 are associated with delayed disease progression. In contrast, smoking and binge alcohol consumption significantly increase the risk of CKD worsening. In diabetic CKD persistent hyperglycemia, altered lipid metabolism, chronic low-grade inflammation, over activation of the renin-angiotensin-aldosterone system (RAAS), and overhydration contribute to accelerated renal decline. The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend maintaining blood pressure below 140/90mmHg in patients without albuminuria and below 130/80mmHg in those with albuminuria. Current medical therapies target fibrosis, inflammation and epigenetic alterations, with RAAS inhibitors, sodium-glucose contransporter-2 (SGLT2) inhibitors, pentoxifylline, finerenone and emerging endothelin receptor antagonists demonstrating promising reno protective effects.