How Should People With Kidney Disease Exercise?

ali.ma@wecistanche.com

Chronic kidney disease (CKD) patients will gradually experience different degrees of cardiopulmonary function decline, muscle atrophy, and exercise tolerance with the decline of renal function, which seriously affects the quality of life of patients. Current research suggests that patients with chronic kidney disease should perform exercise rehabilitation appropriately according to their own conditions and physical conditions. Reasonable exercise can increase patients' cardiorespiratory endurance, improve muscle strength, improve immune function, reduce the risk of cardiovascular disease, improve protein-energy consumption and inflammatory state, delay the progression of Chronic Kidney Disease, and thus improve the quality of life. Therefore, all patients must be active, and don't stop exercising just because they are sick!

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How do people with chronic kidney disease exercise?

According to the "Expert Consensus on Exercise Rehabilitation for Adult Chronic Kidney Disease Patients in my country (2019)", Chronic Kidney Disease patients should formulate individualized exercise guidance according to the patient's basic exercise status and Chronic Kidney Disease stage, including the following aspects:

Exercise frequency: Patients of all stages of Chronic Kidney Disease need moderate-intensity exercise training at least three times a week in addition to daily exercise.

Exercise intensity: Moderate-intensity aerobic exercise and resistance exercise are recommended for patients with all stages of Chronic Kidney Disease to safely and effectively improve physiological function, cardiovascular endurance, and muscle strength.

Exercise time: The target time is 30-60 minutes of moderate-intensity exercise each time, which can be performed in stages according to the individual conditions of Chronic Kidney Disease patients.

Sport type

There is currently no restriction on a particular sports mode. The suggested exercise pattern should include aerobic exercise, resistance exercise, and flexibility training. Is the term a bit confusing? It doesn't matter, let me explain to you one by one:

• Aerobic exercise

Aerobic exercise refers to an exercise method that mainly uses aerobic metabolism to provide the energy required for exercise. Aerobic exercise can exercise heart and lung function, so that the cardiovascular system can transmit oxygen to every part of the body more efficiently and quickly.

Through regular aerobic exercise, the heart function of the human body is stronger, the pulse output is more, the oxygen supply capacity is stronger, and the pulse rate will be appropriately reduced. A person with good heart and lung function can participate in aerobic exercise for a long time, and exercise recovery is also faster.

Common aerobic sports include walking, jogging, skating, swimming, cycling, fitness dance, aerobics, etc.

• Resistance exercise

Refers to the active movement of the muscles to overcome external resistance. This type of exercise can restore and develop muscle strength and is widely used for muscle atrophy caused by various reasons.

Common resistance exercise programs include: stretching pullers or elastic bandages, lifting dumbbells, sit-ups, push-ups, etc.

• Flexibility training

Use gentle muscle stretches and slow-motion exercises to increase muscle flexibility and range of motion in people with CKD, helping to prevent muscle strain or tearing during other sports.

Generally, it is combined with aerobic exercise training and carried out in the preparation and end stages of sports training, including Tai Chi, square dance, Baduanjin, etc.

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So what is the moderate-intensity exercise that we have been emphasizing?

This refers to exercise that consumes 3 to 6 times the energy of basal metabolism or exercises with an intensity range close to 40% to 60% of the individual's maximum functional capacity. In the newly released "Healthy China Action (2019-2030)" guidelines, adults are encouraged to perform moderate-intensity physical activity for more than 30 minutes each time, or a total of 150 minutes of moderate-intensity or 75 minutes of high-intensity physical activity. In daily life, try to move as much as possible to achieve a physical activity of 6,000 to 10,000 steps per day.

There's also an easy way to judge exercise intensity based on your peak heart rate. For example, a 45-year-old male, when the heart rate is 105-122 times/min, the exercise intensity is moderate; when it is lower than 105 times/min, the exercise intensity is low intensity; and when it is higher than 122 times/min, the exercise intensity is low. Exercise intensity is high intensity.

Usually, moderate-intensity physical exercises include jogging, climbing stairs, biking on slopes, skating, playing volleyball, climbing, etc., and last about 10 minutes. You can also buy smart bracelets or watches. At present, many brands of products can record the time of exercise, including medium and high-intensity exercise.

For children and teens: Walking and brisk walking at a speed of about 5 km/h, cycling at a speed of 16 km/h, non-competitive sports-specific basic training, such as swimming, basketball, football, volleyball, badminton, table tennis, tennis, rugby , martial arts and taekwondo, etc., are all moderate-intensity sports.

For adults and the elderly: Walking and brisk walking at a speed of about 5 km/h, and housework activities including cycling at a speed of 16 km/h, grocery shopping, holding children, mopping the floor, and cleaning are also moderate-to-high-intensity sports for adults.

Precautions for exercise in patients with CKD:

1. Monitor blood pressure:

If blood pressure is not well controlled, especially when combined with severe high blood pressure (such as blood pressure over 180/110mmHg) or low blood pressure (<90/60mmHg), it is not suitable for exercise, you should go to the hospital as soon as possible, adjust the medicine, and wait until the blood pressure gets better. Once you have good control, start exercising.

2. Combined cardiopulmonary disease:

If combined with uncontrolled severe heart failure, arrhythmia, unstable angina pectoris, valvular stenosis, hypertrophic cardiomyopathy, aortic dissection, acute exacerbation of chronic bronchitis, acute asthma, etc., it is temporarily not suitable for exercise. After remission, you can exercise gradually and reasonably under the guidance of a doctor.

3. other:

If combined with severe edema, osteoarthritis, deep vein thrombosis of limbs, limb infection accompanied by swelling, pain, it is necessary to suspend or stop exercising.

Indications for cessation of exercise rehabilitation training in patients with CKD:

Since many patients with chronic kidney disease will have a variety of diseases, they must pay attention to gradual, reasonable, and scientific exercise during exercise. It is necessary to pay attention to excessive exercise not only can not play a role in strengthening the body but also cause serious adverse consequences.

Therefore, don’t be stubborn. If the following conditions occur, you should stop exercising immediately and seek medical attention in time:

• Burning pain, soreness, and constriction in areas such as the chest, arms, neck, or jaw

• Severe chest tightness, shortness of breath, difficulty talking; irregular heartbeat or pulse (arrhythmia)

• Headache, dizziness, blackness, general weakness, falls

• Exercise-related muscle spasms, joint pain, etc.

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Summarize

Moderate and scientific exercise is beneficial to the health of kidney patients, and can significantly reduce the risk of cardiovascular disease, improve immunity, delay the progression of CKD, and improve the quality of life.

CKD patients are recommended to perform moderate-intensity aerobic exercise, resistance exercise, and flexibility exercise, 30 to 60 minutes per exercise, 3 to 5 times a week.

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