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Beyond the Kidney: Managing Chronic Kidney Disease in the Era of Cardio-Metabolic-Kidney Syndrome

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 1128

Special Issue Editors


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Guest Editor
Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy
Interests: clinical nephrology; chronic kidney disease; ADPKD; physical activity; DKD-MBD; kidney stones

E-Mail Website
Guest Editor
Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy
Interests: kidney transplant; kidney disease; renal Impairment; clinical nephrology

Special Issue Information

Dear Colleagues,

This Special Issue aims to address the evolving landscape of chronic kidney disease (CKD) management within the broader framework of cardio-metabolic-kidney (CMK) syndrome. Despite advances in pharmacological therapies—such as RAAS inhibitors, SGLT2 inhibitors, and MRAs—key challenges remain, including suboptimal implementation of lifestyle interventions and fragmented care across specialties. The growing recognition of CMK syndrome underscores the need to move beyond organ-specific treatment and adopt a multidisciplinary strategy targeting shared risk factors like hypertension, obesity, dyslipidemia, and insulin resistance.

This Special Issue welcomes original research and reviews focused on integrated therapeutic approaches, including pharmacologic innovations, nutritional and exercise-based interventions, patient-centered care models, and emerging biomarkers or digital tools for early detection. By bringing together nephrology, cardiology, endocrinology, and primary care perspectives, this Special Issue seeks to mobilize a collaborative research community to overcome systemic gaps and improve patient outcomes.

Researchers and clinicians are encouraged to contribute studies that reflect the complexity of CKD within the CMK context, helping to build a more effective and inclusive model of chronic disease management.

Dr. Maria Amicone
Prof. Dr. Antonio Pisani
Guest Editors

Manuscript Submission Information

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Keywords

  • chronic kidney disease
  • disease-modifying therapy
  • physical exercise
  • cardio-metabolic-kidney syndrome
  • SGLT2 in-hibitors
  • MRA
  • renal nutrition
  • innovative therapies
  • low protein diet

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Published Papers (1 paper)

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Research

16 pages, 468 KB  
Article
Characteristics, Attitudes and Preferences of an End-Stage Kidney Disease Population at the Beginning of an Exercise Program: A Pragmatic Multicenter Trial
by Giovanni Piva, Francisco Labrador, Claudia Momenté, Nicola Lamberti, Anna Crepaldi, Alessio Di Maria, Yuri Battaglia, Alejandro Martin-Malo, Fabio Manfredini, Pablo Jesus Lopez-Soto and Alda Storari
J. Clin. Med. 2026, 15(4), 1547; https://doi.org/10.3390/jcm15041547 - 15 Feb 2026
Viewed by 487
Abstract
Background/Objectives: This multicenter nonrandomized pragmatic trial (NCT04282616), offering different options for active support by an exercise facilitator (EF) in the dialysis unit, aims to explore the attitudes and preferences of end-stage kidney disease (ESKD) patients in relation to their characteristics, capabilities and [...] Read more.
Background/Objectives: This multicenter nonrandomized pragmatic trial (NCT04282616), offering different options for active support by an exercise facilitator (EF) in the dialysis unit, aims to explore the attitudes and preferences of end-stage kidney disease (ESKD) patients in relation to their characteristics, capabilities and barriers. Methods: In six European dialysis units, an EF was set to offer to each ESKD patient able to walk four simple low-cost three-month interventions: (i) advised physical activity increase (U-PA-I); (ii) structured home-based walking exercise (S-HB-LI); (iii) in-hospital (pre/postdialysis) supervised walking and resistance low-intensity training (S-SU-LI); and (iv) performance assessment only (PPA). After collecting attitudes and perceptions of patients, the EF was available for counseling about the choice. Outcome measures were the percentage of engaged patients among the total population, the percentage of active interventions versus PPA and their distribution among the available options, as well as the factors related to patients’ choices (anthropometry, clinical, exercise capacity, and others). Results: Of the 297 eligible patients, 221 met the inclusion criteria, 176 (59%) of whom chose to participate (males, n = 113; aged 68 ± 10 years). The patients’ choices were as follows: S-SU-LI, (n = 80), S-HB-LI (n = 66), PPA (n = 25) and U-PA-I (n = 5). Patients in the LI group were significantly older (p < 0.001) and had a lower exercise capacity, as measured by the 6 min walking distance (p < 0.001). No significant differences in sex, distance from the dialysis center, dialysis duration, or recruiting site were recorded. The main reasons for nonparticipation were not being interested (67%) or already active (22%). Conclusions: In this exploratory research, patients exhibited positive attitudes toward exercise training and abandoning a sedentary lifestyle when counseled by an EF and when offered the possibility to choose. As the patient profile becomes more comorbid and frail, supervised and/or lower-intensity programs are preferred. Full article
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