WHY KIDNEY PATIENTS SHOULD EXERCISE

Stephen Z. Fadem and Michelle (Misha) L. Nguyen

There are multiple health benefits of exercise. Exercise may prolong longevity, as well as help control obesity, heart disease, diabetes, and kidney disease. The mental benefits of exercise include reducing anxiety and depression, improving self-esteem and confidence, and boosting memory and cognitive function. Persons who exercise look and feel better; they have greater endurance and more stamina; they also sleep better. Age-related muscle loss, or sarcopenia, is a natural part of the aging process. In fact, after age 30, one begins to lose as much as 3% to 5% muscle mass per decade. We can prevent loss of muscle mass and function from getting worse by incorporating progressive resistance exercises. Exercise is crucial for people with arthritis. It reduces joint pain and stiffness related to arthritis, increases strength and flexibility, and helps maintain bone strength. Stronger muscles help keep the bones stable. In kidney patients, there is a tendency for bones to weaken as the body tries to compensate for diminished renal function. This can lead to increased fractures. The calcium that is leached out of bone to help buffer metabolic acidosis might deposit in blood vessels. This creates stiffened blood vessels, obstruction of blood flow, as well as other additional problems. 

Exercise participants should have goals such as increasing balance, strength, posture, flexibility, and conditioning. Working on specific exercises designed to improve balance may help prevent falls and injuries, as well as improve stability. Utilizing a personal trainer helps clients with promoting fitness while maximizing effectiveness and minimizing injury. Key points of a successful program include setting goals, utilizing proper form, as well as improved health, increased accountability, increased self-confidence, and a greater feeling of overall well-being. Overtraining leads to muscle pain and can cause a decline in performance. It can also lead to injury. 

Kidney patients should speak with their doctor about low-intensity aerobic (e.g., walking and cycling) and resistance training exercises (i.e., any exercise that causes the muscles to contract against an external resistance by utilizing weights, resistance bands, or body weight). We recommend beginning at low intensity and increasing gradually. Begin the exercise routine with warmups and stretches. Wear loose-fitting clothing and proper footwear. Cool down afterward for around 5 minutes. Persons who have had a recent myocardial infarction should work through a cardiac rehabilitation center when getting back to exercising. Sarcopenia, or the loss of muscle tissue, is worse with kidney patients. 

The scientific evidence shows there is a benefit to exercise for chronic kidney disease (CKD) patients. A systemic review of 32 clinical research studies showed that quality of life, physical fitness, and walking capacity all improved (1). Exercise is recommended as part of a kidney-management program to modify the risk factors that can lead to progressive kidney disease. The recommendations are similar to those for the general population (2).

The book, Staying Healthy with Kidney Disease, published by Springer Nature, and soon to be released, demonstrates several exercises that are beneficial for seniors. This chapter is co-authored by Michelle (MishaFit), a certified personal trainer with many years of experience in dealing with persons of all ages, including the senior population. 

References:

1.         Heiwe S, Jacobson SH. Exercise training for adults with chronic kidney disease. Cochrane Database Syst Rev. 2011(10): CD1003236.

2.         Stevens PE, Levin A, Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group M. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Annals of internal medicine. 2013;158(11):825-30.

Photo credit: MishaFit