Chronic kidney disease (CKD) is a complex, progressive condition that affects at least one in ten adults. If left untreated, CKD can have severe consequences, as the kidney function may gradually decline, increasing the risk of adverse health outcomes and mortality. An appropriately adjusted nutrition offers significant benefits in the management of CKD, yet it often remains overlooked as a part of comprehensive patient care. Recent clinical guidelines frequently highlight the Mediterranean diet (MD), as one of the most effective dietary patterns for the prevention of chronic non-communicable diseases and for promoting cardiovascular health. Although direct evidence of protective effects of the Mediterranean diet (MD) on kidney health is still limited, such an approach may contribute to a more favourable disease course and improved overall patient well-being. In the first part of our study, which included 199 patients with CKD, we aimed to gain a deeper insight into lifestyle habits and nutritional status. Participants first completed a specific questionnaire on diet and physical activity, followed by simple physical performance tests, body composition measurements using the Bodystat QUADSCAN 4000m device, and biochemical analyses of blood and urine. As expected, we found that most patients did not adhere to MD guidelines, they consumed plant-based foods less frequently, were insufficiently physically active, and showed lower physical performance. In the second part of the study, we conducted a 4-week intervention with 14 patients, which was based on the MD and increased physical activity. After the intervention, we observed a statistically significant increase in Medas questionnaire scores and dietary fiber intake, indicating high adherence to MD and an increased intake of plant-based foods. Despite higher fiber intake, potassium, phosphorus, and bicarbonate levels remained unchanged. The intervention also had favourable effects on body weight, waist circumference, sodium intake, LDL cholesterol levels, and vitamin D status. The post-intervention results suggest that the MD combined with physical activity is beneficial for patients with CKD, though an individualized approach and the involvement of a clinical dietitian remain essential.
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