Top 7 Fitness Exercise Tips for Kidney Patients

Regular exercise improves muscle function, helps control blood pressure, lowers cholesterol and increases quality of sleep.

Despite the multiple benefits, many chronic kidney disease patients do not exercise enough due to concerns regarding what type of exercise they can do, how often they should exercise and how to create a fitness schedule.

This month, the National Kidney Foundation answers 7 common fitness questions from CKD patients.

1. What types of exercise can I do?
   Choose continuous activity such as walking, swimming, bicycling (indoors or out), skiing, aerobic dancing or any other activities in which you need to move large muscle groups continuously.

Low-level strengthening exercises may also be beneficial as part of your program. Design your program to use low weights and high repetitions, and avoid heavy lifting.
One simple way to exercise and help many others with CKD is to join a local Kidney Walk

2. How often and for how long should I exercise for?
   Exercise at least three days a week. These should be non-consecutive days, for example, Monday, Wednesday and Friday. Three days a week is the minimum requirement to achieve the benefits of your exercise. Work toward 30-minute sessions. Remember to build up gradually to this level.

3. Can I take part in vigorous physical activity?
   Yes. In the past, it was thought that people with kidney disease would not be able to join in vigorous activity. We know now that patients who decide to follow an exercise program are stronger and have more energy.

4. How hard should I work while exercising?
   This is the most difficult to talk about without knowing your own exercise capacity. Usually, the following ideas are helpful:
• Your breathing should not be so hard that you cannot talk with someone exercising with you. Try to get an exercise partner such as a family member or a friend.
• You should feel completely normal within one hour after exercising. If not, slow down next time.
• You should not feel so much muscle soreness that it keeps you from exercising the next session.

The intensity should be a "comfortable push" level. Start out slowly each session to warm up, then pick up your pace, then slow down again when you are about to finish. The most important thing is to start slowly and progress gradually, allowing your body to adapt to the increased levels of activity.

5. When should I exercise?
   Try to schedule your exercise into your normal day. Here are some ideas about when to exercise:
• Wait one hour after a large meal
• Avoid the very hot times of the day
• Morning or evening seems to be the best time for exercising
• Do not exercise less than an hour before bedtime

6. When should I stop exercising?
   You should stop exercising if you feel any of the following:
• Very tired
• Shortness of breath
• Chest pain
• Irregular or rapid heart beats
• Sick to your stomach
• Leg cramps
• Dizzy or light-headed

7. Are there any times when I should not exercise?
   Yes. You should not exercise without talking with your doctor if any of the following occurs:
• You have a fever
• You have changed your dialysis schedule
• You have changed your medicine schedule
• Your physical condition has changed
• You have eaten too much
• The weather is very hot and humid
• You have joint or bone problems that become worse with exercise

If you stop exercising for any of these reasons, speak to your doctor before beginning again.

Low level of self-reported physical activity in ambulatory patients new to dialysis. Kidney Int. 2010 Sep 1. Johansen KL, Chertow GM, Kutner NG, Dalrymple LS, Grimes BA, Kaysen GA. [1] Medical Service, Nephrology Section, San Francisco VA Medical Center, San Francisco, California, USA [2] Department of Medicine, University of California, San Francisco, California, USA.
Physical exercise among participants in the Dialysis Outcomes and Practice Patterns Study (DOPPS): correlates and associated outcomes. Nephrol Dial Transplant. 2010 Apr 13. Tentori F, Elder SJ, Thumma J, Pisoni RL, Bommer J, Fissell RB, Fukuhara S, Jadoul M, Keen ML, Saran R, Ramirez SP, Robinson BM. Arbor Research Collaborative for Health, Ann Arbor, MI, USA.
Exercise in end-stage renal disease. Segura-Orti E, Johansen KL. Department of Physical Therapy, Universidad CEU-Cardenal Herrera, Valencia, Spain. Semin Dial. 2010 Jul;23(4):422-30.

 

New Feature from Hemodialysis.com: Hemodialysis or Chronic Kidney Disease Abstract of the Week

Automated Intravascular Access Pressure Surveillance Reduces Thrombosis Rates. Semin Dial. 2010 Aug 13. Zasuwa G, Frinak S, Besarab A, Peterson E, Yee J. Division of Nephrology and Hypertension, Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan. Although monitoring of vascular accesses by physical examination is nearly as sensitive as surveillance measurements by vascular access pressure when performed by examiners, the frequency of examinations is limited by time. We developed intravascular access pressure surveillance as a surrogate to physical examination. Using real-time data from hemodialysis machines, we derived intravascular access pressure ratios for each dialytic procedure. An automated, noninvasive surveillance algorithm that generated a "warning" list of patients at risk for thrombosis was formulated. We hypothesized that this algorithm would reduce access thrombosis frequency. We designed a study comparing thrombosis rates during a baseline 6-month interval to three subsequent 6-month periods of active surveillance. Referrals for interventions during this 18-month period were based on persistently abnormal elevated vascular access pressure ratio tests (VAPRT) >0.55. Thrombosis rates declined progressively for arteriovenous grafts (AVG) during the intervention period compared with the baseline period. Arteriovenous fistula (AVF) thrombosis rates decreased during postintervention months 13-18 during employment of the VAPRT. We conclude that use of VAPRT can reduce thrombosis rates in vascular accesses, and the magnitude of the effect is larger and more consistent in arteriovenous grafts (AVGs) than autologous AVFs.

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