Exercising With Chronic Kidney Disease

Reviewed by: HU Medical Review Board | Last reviewed: February 2023

Everyone can benefit from regular exercise, including people with chronic kidney disease (CKD). It takes time and commitment, but getting more physical activity will make you feel better overall. Plus, feeling stronger and having more energy can combat some of the negative symptoms of living with CKD.1

Benefits of regular exercise for people with kidney disease include:1

  • A stronger heart
  • Better control of blood pressure and blood sugar
  • More muscle mass and stronger muscles
  • Less anxiety and depression
  • Better weight management
  • Better sleep

Sitting all day or staying in bed may be tempting, but lack of activity causes you to lose muscle and strength. This could lead to you not being able to move on your own and becoming disabled.1

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Getting started

If you have not been exercising at all, talk to your doctor before starting any new routines. They will likely suggest that you build 3 types of exercise into your week:1

  • Stretching exercises
  • Strength training
  • Endurance (cardiovascular or aerobic) exercise

All 3 types of exercise play a different role in your overall health, so you need a combination of the 3. However, if you have not been active at all or are weak, start with gentle stretches and light strength training. You can gradually work up to aerobic exercise.1

Stretching exercises

Stretching exercises improve your flexibility, reduce stiffness, and help improve how far and how easily you can move. Stretching should be done 4 to 7 days a week, but it does not have to be time-consuming. It should include a combination of stretches for the:1

  • Arms
  • Chest
  • Head and neck
  • Legs

For each exercise, move into position until a muscle feels stretched, then hold for 10 seconds. Repeat each stretch 3 to 5 times.1

Strength training

Many people think of weight lifting when they hear the words "strength training." But any exercise that makes muscles stronger counts as strength training. These can include:1

  • Climbing stairs
  • Stepping up and down off of a step or a curb
  • Getting up and sitting back down in a chair several times
  • Standing in place and raising and lowering yourself on your toes

If you feel up to it, lifting weights may be an option for you. Like with all exercise, you should start slowly and gradually build strength. Eventually, you want to work all the major muscle groups. Repeat each movement 12 to 15 times per set, and do 2 to 3 sets.1

You do not have to buy weights or elastic bands if you do not have them. You can lift soup cans, detergent bottles, or other heavy objects you have around the house.1

Endurance exercises

Exercise that improves your circulation and helps your heart can be called endurance, cardiovascular, or aerobic exercise. This type of exercise is best for improving the energy you have during the day. Examples include:1

  • Walking
  • Swimming
  • Dancing
  • Riding a bike riding

You should try to get this type of activity most, or all, days of the week. Go at a pace that increases how hard you breathe.1

If you are just starting this type of exercise, start small and work your way up to longer and harder sessions. For example, you may start walking 10 minutes a day. After a week or so, try walking for 12 to 15 minutes a day.1

The goal is to build up to 30 to 45 minutes of aerobic exercise in a single session most days of the week. But if you need to break that up into smaller chunks of time, that is okay too.1

How much exercise is too much?

You may have heard the saying "no pain, no gain," but it does not apply to exercising when you have CKD. Your exercise routine should not cause pain. Listen to your body as you move, and slow down if:1

  • An exercise feels hard
  • You feel pain in a muscle or joint
  • You are breathing too hard to talk to someone else
  • Your heart is racing
  • You do not feel recovered 1 hour after exercise

Exercise while you are on dialysis

Studies show that people on dialysis are healthier if they get regular exercise. One study found that people using peritoneal dialysis had healthier weights, more muscle, and better bone health if they engaged in moderate to vigorous exercise. Moderate to vigorous exercise was defined as 2,020 to 6,000+ steps per day.2

A summary of several other studies found that aerobic exercise resulted in less tiredness and depression in people on hemodialysis.3

Remember, everyone has high-energy days and low-energy days. If it is a low-energy day, it is okay to exercise a little less or go more slowly than normal. The most important thing is to stick with it and be consistent so you can build strength and flexibility over time.1

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