Modifying Lifestyle: Basis of Kidney Health Management

There are limited studies investigate the relationship between healthy lifestyle and the progression of chronic kidney problems. A narrative review has summarized different studies to prove the connection. The author finds out most people with chronic kidney problems do not adhere to several healthy lifestyle recommendation.

Exercise

Studies has revealed that reduced physical activity is associated with increased mortality and more chronic kidney problems, but its relationship to chronic kidney problems progression is less known. A research indicates that each 60 minutes-greater duration of exercise is associated with 0.5% per year slower decline in eGFR. Another research reports that doing physical activity more than one time per week in older adults (mean age 70 years old) is associated with reduced risk of end stage kidney problems. However, it does not show the same outcome in younger people. To summarize, sufficient exercise might be possible in slowing down kidney function decline, especially in older adults, any types of physical activity might lower the chance of getting end-stage kidney problems. However, those research have a few limitation. More studies and data are required for further assessment.

Tobacco Use

Smoking is one of the major risk factor for chronic kidney problems. In the early stage, current cigarette smokers have been discovered to have greater eGFR decline per year compared to nonsmokers. Several studies indicate that the risk of chronic kidney problem progression of former smokers is lower than that of current smokers, and the longer the smoking cessation time, the lower the risks. A clinical trial recruits 216 people under treatment for stage 2 kidney problems, the ratio of current smokers and nonsmoker are 50:50. In the clinical trial, current smokers undergo a smoking-cessation program. After 5 years of follow up, both nonsmokers and former smokers have a higher eGFR than current smokers. Although more supporting data is needed to prove the benefits of smoking cessation to slowing down kidney function decline, the author still believe smoking cessation has a huge potential benefit.

Weight Management

A study published by UK Biobank suggests there is a causal relationship between excess weight problems and chronic kidney problems. Current guidelines encourage people suffered from those issues to lose weights. However, the result of intentional weight loss to slow down chronic kidney problem progression is mixed, and largely depends on the type of weight reduction method, such as diet, exercise, surgery, and medications. The author found out that bariatric surgery has most consistent result of showing beneficial effect of weight loss on kidney function.

Although most studies lack evidence from large trails, the author still believe maintain a healthy lifestyle is the cornerstone of chronic kidney problem management.