Short-Term Effects of Structured Physical Activity With or Without Dietary Counselling in Early-Stage Chronic Kidney Disease Managed in Primary Care: A Non-Randomised Controlled Study.

Background/Objectives: To evaluate the short-term effects of structured physical activity (PA), alone or combined with dietary counselling, in early-stage chronic kidney disease (CKD) patients managed in primary healthcare (PHC). Methods: This non-randomised controlled study was conducted in Croatia from 1 September to 30 November 2025. Ninety adults aged 40-75 years with early-stage CKD were allocated to three groups: structured PA, combined PA and dietary counselling, or control. Interventions included kinesiologist-led PA and, in the combined group, dietitian-led Mediterranean/plant-based counselling. Outcomes included estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (ACR), cardiometabolic risk factors, behavioural measures, quality of life, and sleep quality. Statistical significance was set at p < 0.01. Results: Seventy-eight participants completed follow-up. Changes in eGFR did not differ between groups (p = 0.310). Mean ± standard deviation changes in ACR were -1.10 ± 6.37, -0.86 ± 2.88, and +1.18 ± 3.13 in the PA, combined, and control groups, respectively (p = 0.017, not meeting the prespecified significance threshold). Significant between-group differences were observed for selected patient-reported and PA outcomes, including emotional well-being, energy/fatigue, role limitations due to emotional problems, sedentary time, and total PA (all p ≤ 0.006). Conclusions: Structured PA, with or without dietary counselling, improved PA behaviour and selected patient-reported outcomes in early-stage CKD managed in PHC but did not demonstrate significant short-term effects on kidney-related outcomes. These findings support the feasibility of integrating lifestyle-oriented interventions into PHC as part of integrated CKD care, while larger, longer-term studies are needed.