What lifestyle modifications should I recommend to a patient with mildly reduced GFR to prevent progression of kidney disease?

For a patient with mildly reduced glomerular filtration rate (GFR), recommend the following lifestyle modifications to help prevent progression of kidney disease:

• Encourage regular physical exercise to maintain overall health and support kidney function.
• Advise achieving and maintaining a healthy weight to reduce strain on the kidneys and associated comorbidities.
• Strongly recommend smoking cessation as smoking is a risk factor for CKD progression.
• Provide dietary advice tailored to the severity of CKD, including appropriate intake of potassium, phosphate, calories, and salt to avoid further kidney damage.
• Avoid chronic use of NSAIDs due to their association with decreased GFR and potential to accelerate CKD progression.

These lifestyle changes should be supported by education and information tailored to the patient's condition to enable informed self-management and shared decision-making.

Monitoring and managing other risk factors such as hypertension, diabetes, and cardiovascular disease are also important but pertain to clinical management beyond lifestyle advice.

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