Nutrition & Exercise Guide

Dietary Principles

A reasonable diet helps control blood pressure, slow the decline of kidney function, and improve overall health. The following principles apply to most ADPKD patients, but specific implementation should be combined with your individual CKD stage and your physician's advice.

• Low sodium: Limit daily salt intake to < 5 g (approximately 2,000 mg sodium); reduce pickled and processed foods
• Moderate protein: Generally recommended at 0.8 g/kg/day; further restriction may be needed after reaching CKD stage 3, as assessed by your physician
• Adequate hydration: Follow your physician's guidance on fluid intake; patients with normal kidney function are generally encouraged to drink adequate water, while in advanced stages adjustments are based on urine output
• Limit caffeine: Caffeine may stimulate cyst fluid secretion; moderate control of coffee, strong tea, and energy drinks is recommended

Dietary Adjustments by CKD Stage

As kidney function declines, the focus of dietary management shifts. The following are stage-based recommendations; specific plans still require physician assessment.

• Stages G1–G2: Kidney function is essentially normal; diet can closely resemble that of the general population, with emphasis on controlling sodium and caffeine
• Stage G3: Protein intake needs to be restricted; monitor blood phosphorus levels and reduce high-phosphorus foods (such as organ meats and carbonated beverages)
• Stages G4–G5: Strict restriction of potassium and phosphorus intake is needed; avoid high-potassium fruits and vegetables (such as bananas, oranges, and potatoes); specific lists should be guided by a dietitian

Recommended Exercises

Regular low-to-moderate intensity exercise helps control blood pressure, maintain cardiopulmonary fitness, and support emotional well-being. A cumulative total of approximately 150 minutes per week is recommended.

• Walking: The easiest to implement; suitable for patients at all stages
• Swimming: Joint-friendly; full-body aerobic exercise
• Cycling: Indoor stationary bikes or outdoor flat-road riding are both fine
• Tai Chi: Gentle and stretching; combines physical and mental relaxation

Exercises to Avoid

ADPKD patients often have enlarged kidneys, and external impact may cause traumatic cyst rupture and bleeding. The following exercises require caution or should be avoided.

• Contact sports: Such as soccer, basketball, rugby, and combat sports
• Weightlifting: High-load activities that increase intra-abdominal pressure may increase risk
• Intense competitive activities: Events with a high probability of falls or collisions

Exercise Precautions

• History of cyst hemorrhage: Patients who have previously had cyst bleeding should have their exercise plan assessed by a physician before resuming activity
• Greatly enlarged kidneys: When kidney volume is markedly increased, avoid movements that raise intra-abdominal pressure; appropriate intensity should be assessed by your physician
• Gradual progression: Start at low intensity and increase gradually; avoid sudden strenuous exercise
• Listen to your body: Stop immediately and seek medical evaluation if you experience pain, dizziness, or palpitations during exercise

Dining-Out Strategies

When eating out, sodium and processed ingredients are often difficult to control. The following strategies can help reduce risk.

• Choose low-salt dishes: Prefer steamed, blanched, or cold dishes; avoid braised, sauce-heavy, or dry-pot style dishes
• Avoid processed foods: Reduce sausages, cured meats, canned goods, and frozen pre-packaged meals
• Ask about seasonings: When ordering, ask whether MSG, soy sauce, or oyster sauce is added; you can request less salt or sauces on the side
• Control portions: Avoid overeating in one sitting; consider sharing or taking leftovers home

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