Exercises Tailored for Chronic Kidney Disease on Dialysis

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A dialysis lifestyle with limited physical activity can increase the risk of depression, high blood pressure, weakened immune function, heart disease and swelling in the feet and legs.  Many dialysis patients think they cannot do any exercise because they can't do "normal" exercise.  However, even a little regular exercise for short periods like 15 to 20 minutes,  tailored to End Stage Renal Disease (ESRD) patients, can help them feel better.

  While regular exercise will cause a healthy blood flow, strengthen muscles, and improve immune function, it will also help maintain healthy tissue leading to proper digestion, absorption and metabolism. Dialysis patients must discuss the importance of not overheating during exercise, which can lead to increased fluid consumption and fluid overload.  Although heavy weight lifting should be avoided (not necessarily light weights) due to the access fistula usually located on the arm,  those with heart conditions may benefit from a program with staff that is trained to work with cardiac-renal patients.

It is fine to exercise to a point where you feel tired and a bit short of breath and your muscles ache afterwards. However, you should not exercise to the point of exhaustion. Symptoms such as chest pain, unexpected shortness of breath, or severe muscular or joint pain should cause you to stop exercising and seek your doctor’s advice.

There are many indoor exercises you can do on dialysis, but before you start any type of exercise, KidneyBuzz.com suggests that you  ask your Nephrologist which exercises are best for you personally.  For example many patients on dialysis can stretch. Stretching helps warm up the muscles that you plan to work out by getting the blood circulating throughout your body. And one of the best parts about stretching is that you can do it anywhere and don’t need special workout equipment. You can stretch before exercising, as well as afterward to help you wind down. Again, ask your Nephrologist about the types of stretching you can do and the right way to do it. Specifically, ask if there are any precautions you need to take so you do not harm your vascular access.

Cardio workouts are important for people on dialysis. Cardio is short for “cardiovascular,” so this type of exercise mainly benefits the heart. If you have a home gym or are looking to put one together, a treadmill or stationary bike can be used for indoor cardio exercise. Not everyone's home can fit a large piece of exercise equipment, so an alternative is to jog in place to get your heart rate up. You can log your progress each day by timing how long you work out. If you have a staircase in your home, walk up and down the stairs (using a hand rail) for your cardio needs. And if you don’t have stairs, consider going to a local indoor mall for a brisk walk. You may want to grab a friend or family member to go with you. Tell them that you intend to walk around the mall a few times before actually stepping into a store. You’ll get your workout done and afterward you can browse the aisles of your favorite store.

For people on dialysis who either have a fistula in their arm or an abdominal catheter for peritoneal dialysis, lifting weights should be discussed with your Nephrologist first. S/he may recommend that you lift light weights to avoid harm to your vascular access. Lifting even light weights every other day can help increase blood flow, build muscle and help you become stronger. Lifting weights can be done while watching television in your home or at your local gym in a weight room. If you gain or lose weight you should inform your healthcare team so they can adjust your treatment plan accordingly.

Calisthenics are exercises designed to help strengthen and improve the body’s flexibility by using your own weight for resistance. Similar to stretching, there is no need to use workout equipment for these exercises; you can add this type of workout alongside your stretching routine. Calisthenics include: Sit-ups, push-ups, pull-ups, jumping jacks, crunches, squats, dips, and calf raises.

 There are a number of indoor activities (not conventional exercise) which people on dialysis can do as a form of exercise. Carrying out different chores around the house, playing with your kids or grandchildren, or organizing a room can get you out of your seat and up on your feet. Here are some activities around the house that can be good exercise: Sweeping, mopping, dusting, vacuuming, laundry, cleaning out your closet, and reorganizing the furniture.

Even though you are indoors, KidneyBuzz.com recommends that you consider wearing a pedometer to monitor your steps around the house or in a shopping center. You can log your daily steps in a fitness journal to track your progress. Also, you can make any of these activities more motivating for yourself by playing your favorite type of music. You could wear headphones, turn up the stereo in your house or play tunes on your computer. Or you may want to watch television while you get through your chore list.



"Safe Exercises for Hemodialysis." LIVESTRONG.COM.

"Indoor Exercises for People on Dialysis." - DaVita.

Recommended Readings:

Many with CKD die from Cardiovascular Disease instead of Kidney Disease
CKD Patients improve Dialysis Outcomes by Exercising During Session
Walking is the Easiest Exercise to Incorporate into Your Daily Life