Can People With CKD Exercise? How Much Physical Activity Should Be Done Per Week? The Guide Gives The Answer

Can people with chronic kidney disease exercise? BMC Nephrology magazine recently released the "Clinical Practice Guidelines for Exercise and Lifestyle in Patients with Chronic Kidney Disease" (hereinafter referred to as "Guidelines"), which has important guiding significance for life management and exercise choices for patients with chronic kidney disease.

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How should non-dialysis CKD patients exercise?

The "Guidelines" recommend that non-dialysis CKD patients with no contraindications and stable disease control should be encouraged to participate in physical activity (1B).

The "Guidelines" suggest that non-dialysis CKD patients can exercise according to the British "Physical Activity Guidelines (2019)" (1B):

Non-dialysis CKD patients should engage in daily physical activity.

Nondialysis CKD patients should engage in activities that improve or maintain muscle strength, balance, and flexibility (at least 2 days per week) to maintain or improve their physical performance.

Non-dialysis CKD patients should engage in 150 minutes of moderate-intensity aerobic exercise per week. People who exercise regularly can try 75 minutes of vigorous-intensity activity per week; or a combination of moderate-intensity and vigorous-intensity activity.

Non-dialysis CKD patients should break their sedentary state with light activity, or at least stand for a while when sedentary when their physical condition permits.

Regular physical activity in non-dialysis CKD patients will help:

Improve blood pressure (1B).

Improvement of physical function (1B).

Improve dysfunction (1C).

Exercise can improve mental health, such as reducing symptoms of depression and anxiety in patients (2C).

The Guidelines recommend that a specified combination of aerobic and muscle-strengthening exercises should be performed to improve muscle function (1C).

Weight Management in CKD Patients

The Guidelines recommend that non-dialysis patients with CKD should regularly measure and monitor (self-monitor when necessary) physical data to assess changes in body composition (1B).

The "Guidelines" suggest that medical staff should provide professional weight management services for non-dialysis CKD patients and deal with them in a timely manner (such as timely referral according to the regional referral pathway when significant changes in the patient's body measurement data are observed) (2D).

How should CKD patients on regular hemodialysis exercise?

The Guidelines recommend that for hemodialysis patients without contraindications, physical activity and exercise should be encouraged (1C).

The "Guidelines" recommend that patients on hemodialysis should do 150 minutes of moderate-intensity exercise (or 75 minutes of high-intensity exercise) per week or a combination of both (2C).

For human hemodialysis patients, moderate exercise can reduce the risk of cardiovascular-related diseases and all-cause mortality (1C).

At the same time, increased exercise may have a beneficial effect on blood pressure (2C).

Exercise is safe for people on hemodialysis (exercise during dialysis); appropriate exercise can:

Improve cardiovascular health and physical function (1B).

Improve muscle strength (2C).

Reduce hospitalization (2C).

Improve blood pressure control (2C).

Improve blood lipids (2D).

Improve dialysis efficiency (2D).

The Guidelines recommend that the development of a physical activity and exercise program should be undertaken by persons qualified to conduct exercise and/or rehabilitation programs in people with chronic disease (2D).

Weight management in hemodialysis patients

The "Guidelines" recommend that regular body measurements should be taken to assess changes in body composition, and it is recommended that CKD patients receiving hemodialysis maintain a body mass index (BMI) between 20 and 30 kg/m2 (1C).

The "Guidelines" recommend that a professional approach to weight management should be taken, including assessment of nutritional needs, management of comorbidities, and enhanced exercise and exercise support (2C).

Bariatric surgery is safe and may be considered for those patients who are too obese to be eligible for transplantation (2C).