Exercise and Chronic Kidney Disease: What do experts recommend?

Having a Chronic Kidney Disease does not have to mean absolute stillness; on the contrary, it is suggested to perform some physical activity. However, there are several points to consider.

Before venturing into any kind of exercise, it is important to consider medical opinion. To do this, we will review some questions of patients with CKD referred to physical activity.

Patients who can exercise with CKD are those considered outpatient, that is, those in a nephroprotection or pre-dialysis program (who already receive hemodialysis or peritoneal dialysis, as well as patients with renal transplantation).

The benefits of exercise for a person with CKD.

For all of them, the benefits of physical activity have been demonstrated in different studies, since blood pressure is reduced, cardiovascular function is improved, blood glucose control is observed (in case of diabetic patients) and increased muscle mass. Also, exercise improves mood, quality of life and sleep pattern.

What exercises can I do?

For people with CKD, only the exercises recommended by the nephrologist and/or treating physician should be done. Here, it is key to take into account the renal function of the patient, as well as the comorbidities that may occur.

As the Leyder Corzo Nephrologist from Baxter Renal Care Services RCS explains, "Each patient and family should directly ask their nephrologist/therapist about the type of exercise (aerobic / resistance), as well as the time, frequency, intensity in which they can do it".
This point is important because on  Internet there are many exercise tips, but not all are ideal for people with CKD. "It is not advisable to make exercise plans that we recommend or that we find on some websites, for example, since the condition of each patient may be different," adds Corzo.

On this subject, the National Kidney Foundation suggests routines that do not exceed half an hour to begin with. They should be exercises that promote the use of several muscles at a time (such as walking, jogging, swimming, and cycling), and that do not leave the patient exhausted.

What exercises should I avoid?

To find out which activities are not suitable, let’s start by keeping in mind the possible preexistences that led me to have chronic kidney disease. For example, if I have a history of heart disease, I should not choose those activities that represent considerable effort at the heart level, or that raise my heart rate to dangerous levels. A similar case is presented in people with hypertension.

The National Kidney Foundation adds that abrupt exercises should be avoided, or that generate particular pressure on some parts of the body, such as weight lifting.

The fatigue generated should not be such as to preclude the person from exercising again two days later, nor should it generate fatigue to the point that the patient has difficulty breathing and cannot speak. Chest pain, cramps, nausea, excessive tiredness and irregular heartbeats are immediate signs to stop the routine that has been performed.

On the other hand, as Corzo explains, "patients with CKD may have electrolyte alterations (sodium, potassium and phosphorus) and hydration. It is very important to take this into account when developing a physical activity, because the nephrologist/ treater should always be consulted". Remember that people with CKD need to stay hydrated at all times, which is why they will need to increase their fluid intake if they perform any exercise and check that their diet is supplying adequate levels of sodium, potassium and phosphorus.