Some dialysis patients may feel that exercise is an unattainable goal. The exhaustion, decreased physical abilities, poor appetite and ill feelings often associated with dialysis can make the suggestion of exercise seem undesirable. The reality is often the opposite. Many dialysis patients can exercise. Doing so may help abate some of the more common side effects that make exercise seem impossible.

Exercise Benefits

The potential benefits of exercise in the dialysis population may include:

• Improved ability to carry out daily activities.²
• Better blood pressure (BP) control and decreased need for BP medications.¹
• Enhanced cardiovascular health.^1,4
• Improvement in risk factors for heart disease (inflammation, total cholesterol, triglycerides, insulin resistance).³
• Increase in muscle strength.^2,3
• Improved quality of life.^1,3
• Decreased anxiety and depression.¹
• Improved sleep.¹
• Improved balance and coordination.⁴

Exercise Tips

• Talk to your doctor. It is important to make sure that you are healthy enough for physical activity. Discuss the possibility of physical activity to get started. Keep your doctor informed about how you are doing once you have started your exercise plan.
•  Start low and go slow. If you haven’t exercised in a while or this is your first foray into fitness, it is always best to start out slowly. A good starting goal is 10 minutes of exercise. Sometimes that could mean just standing up and walking around your house several times a day for 3 to 4 days a week. Aim to increase this activity by 5 minutes a week until you reach at least 30 minutes a day. Always listen to your body when starting or increasing activity.
• Cardiovascular fitness: Walking, stationary biking, easy hikes and swimming are all low impact options to get started.  Avoid water activities if you have a central venous catheter (CVC). If you did more cardio prior to starting dialysis, it may still be a good idea to start low and slow initially. Listen to your body as you progress back toward your previous level of fitness.
• Weight training:  Resistance bands and ankle weights are excellent ways to gain strength and muscle mass. A good goal for these type of moves would be 8 to 10 repetitions. If they are too easy, you can increase band resistance or slow the movement down to increase the difficulty.  If you cannot complete at least 8 repetitions before failure, decrease band resistance by one until you gain more strength and can continue progressing.
  • Tip: Always check your bands for tears before starting any exercise.

• Warming up: If you are weight training, it is vital to start out by warming up. Take about 5 minutes to get your body warm. A short brisk walk or dynamic stretching are good ways to achieve this goal. Warming up before exercise helps to decrease the possibility of exercise-related injuries.
• Cooling down: No matter what type of exercise you do it is always important to cool down and stretch out the muscles you have been using. Static stretching after exercises helps to maintain or increase your range of motion and decrease any soreness or stiffness that may come with exercise.
• Set S.M.A.R.T. goals (Specific, Measurable, Attainable, Relevant, Time-bound)
  • I am going to start working out at home (example of a basic goal).
  • I will start working out on Tuesday, Thursday, and Saturday by walking around the block for 10 minutes followed by 5 minutes of stretching. Once I can do this comfortably I will increase my time walking to 15 minutes. (example of a SMART goal).
• Creating Habits
  • Break your larger goal down into small, attainable steps.
  • Involve family or friends.
  • Write it down.
  • Plan a small treat for when you reach your goal. For example, buy a book you’ve wanted to read

References

1. R.N. Mi Rye Suh, Hae Hyuk Jung, Soon Bae Kim, Jung Sik Park & Won Seok Yang (2002) EFFECTS OF REGULAR EXERCISE ON ANXIETY, DEPRESSION, AND QUALITY OF LIFE IN MAINTENANCE HEMODIALYSIS PATIENTS, Renal Failure, 24:3, 337-345, DOI: 10.1081/JDI-120005367
2. Kirsten L. Johansen (2007) EXERCISE IN THE END-STAGE RENAL DISEASE POPULATION, Journal of the American Society of Nephrology,18:6 1845-1854, DOI: 10.1681/ASN.2007010009
3. Song, Ju & Ahn, Jeong. (2013). EFFECT OF INTERVENTION PROGRAMS FOR IMPROVING MATERNAL ADAPTATION IN KOREA: SYSTEMATIC REVIEW. Korean Journal of Women Health Nursing. DOI: 19. 129. 10.4069/kjwhn.2013.19.3.129.
4. Milam, Rita H. (2016) EXERCISE GUIDELINES FOR CKD PATIENTS. Journal of Renal Nutrition, Vol 26, No 4 (July), 2016: pp e23-e25.