Exercises for Dialysis Patients

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By Siti Noor Huda

A healthy body makes for a healthier mind. For patients with advanced kidney disease who require dialysis, exercising is especially vital to not only help circumvent the fatigue they would feel while undergoing dialysis treatments but to also help them regain a better semblance of normalcy in their daily lives when carrying out everyday activities.

At the outset, many patients with kidney disease – especially those at advanced stages – believe that their condition prevents them from doing any real exercises. This is because limited information is provided to them on this aspect and kidney patients are often excluded from exercise programs as part of their treatment,  more so when compared to patients with other chronic diseases.

Physical fitness is crucial to helping kidney disease patients manage their condition in the long-term and is highly recommended.

However, it is very important for patients to first speak with their doctor, who can recommend which exercise routines suit them best, depending on how advanced their condition is.

A better lease of life through exercising

For dialysis patients, exercising can represent another form of medicine.

On one hand, regular exercise is one of the most direct ways to improve energy levels in the body. This is especially crucial as dialysis patients undergoing treatment will often feel fatigued due to muscle wastage and – in more extreme cases – experience muscle atrophy.

Exercising helps patients utilise their muscles, which then makes it easier for them to move around and gain better flexibility to carry out daily tasks, whether it is for work or household activities. Those who are fitter may even be able to carry out activities that they were able to do before they started their dialysis treatment – giving them more agency in managing their condition. However, it is crucial that patients who exercise keep themselves hydrated, as experts have noted that heavy perspiration may signal the kidneys to save water and keep toxins within the body.

Another key benefit of exercising is to prevent the occurrence of other chronic conditions. A particular risk for dialysis patients who are inactive is developing heart disease, especially if they intake food or substances that could raise cholesterol and blood pressure levels. Regular exercising also helps to reduce or control the risk of diabetes, as muscles are important for regulating insulin resistance and glucose levels.

While the rigorousness of an exercise routine for kidney patients depends on how advanced their affliction is, in general, it is always advisable to start things slowly and measuredly.

Stretching out

The one thing that nearly all dialysis patients can do – no matter how serious their condition is – to stretch. Stretching is important to get the blood flowing to different parts of the body and reduce instances of cramping which would help in exercising more comfortably and could further motivate the patients to exercise more. It also helps to unwind and mentally relax and could even be beneficial to help them sleep better at night.

Starting slowly with warm-ups

Patients should not dive straight into heavier exercises.

It is advisable that they first gently warm up via light cardiovascular activities, such as walking, for several minutes. Near the end of the exercise session, it is also crucial that they slow things down, followed by doing stretches and then relaxing.

Getting more active with interdialytic anaerobic exercises

For patients who have remained inactive for long periods, it can be difficult to accustom themselves to regular exercise routines. Hence, interdialytic exercises – which mostly comprise anaerobic exercise – are now being adopted more regularly as part of the patient’s overall treatment at clinics, especially for patients undergoing haemodialysis. However, there are limitations to interdialytic exercising as it is often stationary; oftentimes being done in beds or while sitting (i.e. using a stationary fitness bicycle). As such, it is recommended that interdialytic exercise be done even outside the confines of clinics, and to be supplemented with personal exercise routines so that patients can incorporate a greater variety of activities into their routines.

Improving resistance

Once patients can do more, the next step is to move towards resistance training, such as exercising using weights or dumbbells, to strengthen their muscles. As mentioned earlier, inactive kidney patients run the risk of suffering from muscle weakness so resistance training helps to address this and by extension, helps them do other exercises more easily and make the conduct of everyday activities easier.

However, it is important that resistance exercises must be hard enough so that patients can only do it for a few times. These exercises can be done using equipment at gyms, but it is advisable to consult with the trainers there on how to use them properly. Resistance training can also be done at home, even with everyday items like tin cans or water-filled buckets. Whether at the gym or at home, these exercises should be done using very controlled movements and they must be done until the muscles tire. Throughout the entire session, it is vital that they breathe normally and do not hold their breath.

Knowing when to stop

While exercising regularly can transform a dialysis patient’s life for the better, they must not be overtly gung-ho about it and remain conscious of their own physical limitations. It is hence vital that they stop immediately if they feel very tired, light-headed and/or start feeling irregular heartbeats.

There are also instances where dialysis patients should avoid exercising at all costs. This includes instances where they have altered either their dialysis or medication schedule. When this happens, it is doubly important for the patients to speak to their doctor before beginning their exercise again.

The importance of taking it easy

No matter at which stage a chronic kidney disease patient is at, exercising will always be beneficial even if different patients need to plan their routines according to their specific condition. The general rule, however, is to take things slowly; it is best to start doing 15-20 minutes of exercise for a few days within a week to better ascertain if they can gradually push themselves further.

Above all, being slow and steady wins a patient’s race of regaining more normalcy and independence in their lives.


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