{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T13:14:07Z","timestamp":1776777247251,"version":"3.51.2"},"reference-count":53,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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\u201375 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 &lt; 0.01. Results: Seventy-eight participants completed follow-up. Changes in eGFR did not differ between groups (p = 0.310). Mean \u00b1 standard deviation changes in ACR were \u22121.10 \u00b1 6.37, \u22120.86 \u00b1 2.88, and +1.18 \u00b1 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 \u2264 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.<\/jats:p>","DOI":"10.3390\/jcm15083169","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T11:42:45Z","timestamp":1776771765000},"page":"3169","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8968-6827","authenticated-orcid":false,"given":"Lorena Bosnar","family":"Zelenika","sequence":"first","affiliation":[{"name":"Zagreb Health Centre\u2014Centar, Runjaninova 4, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragana","family":"Ti\u0161ma","sequence":"additional","affiliation":[{"name":"Zagreb Health Centre\u2014Centar, Runjaninova 4, 10000 Zagreb, Croatia"},{"name":"Department of Kinesiology Recreation and Kinesiotherapy, Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara","family":"Ciko","sequence":"additional","affiliation":[{"name":"Zagreb Health Centre\u2014Centar, Runjaninova 4, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pero","family":"Hraba\u010d","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, Epidemiology and Medical Informatics, \u201cAndrija Stampar\u201d School of Public Health, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Vukovi\u0107 Brinar","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Art. Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9142-1569","authenticated-orcid":false,"given":"Valerija","family":"Brali\u0107 Lang","sequence":"additional","affiliation":[{"name":"Family Medicine Specialist Office, 10000 Zagreb, Croatia"},{"name":"Department of Family Medicine, \u201cAndrija Stampar\u201d School of Public Health, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"ref_1","unstructured":"Bello, A.K., Okpechi, I.G., Levin, A., Ye, F., Saad, S., Zaidi, D., Jha, V., Malik, C., Osman, M.A., and Tonelli, M. (2023). 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