The symptoms and conditions of CKD can make exercising more challenging. However, the sooner you can commit to becoming more active, the more you can do to fight the progression of CKD and its related conditions. Becoming more active at any stage of CKD is beneficial, even if you are on dialysis. The key is creating a personal physical activity plan that is appropriate for your needs and conditions. The increase in CKD in recent decades has paralleled increases in obesity, diabetes, and the metabolic syndrome. Physical inactivity is a modifiable risk factor that may affect the development and course of CKD. It is well established that exercise training improves a number of metabolic factors, including blood pressure and insulin resistance, which would be expected to preserve renal function as well as lower CVD risk.
Can I take part in vigorous physical activity? Yes. People who decide to follow an exercise program are stronger and have more energy.
How does exercise benefit me? With exercise, it becomes easier to get around, do your necessary tasks and still have some energy left over for other activities you enjoy. In addition to increased energy, other benefits from exercise may include:
- Improved muscle physical functioning
- Better blood pressure control
- Improved muscle strength
- Lowered level of blood fats (cholesterol and triglycerides)
- Better sleep
- Better control of body weight
Do I need to see my doctor before starting exercise? Yes. Before beginning any exercise program, be sure to check with your doctor. You should leave your Dr’s office with the following questions answered;
- Type of exercise
- Length of time you spend exercising (Duration)
- How often you exercise (Frequency)
- How hard you work while exercising (Intensity).
Type of Exercise: Choose continuous activity such as walking, swimming, bicycling (indoors or out), skiing, aerobic dancing or any other activities in which you need to move large muscle groups continuously. Low-level strengthening exercises may also be beneficial as part of your program. Design your program to use low weights and high repetitions, and avoid heavy lifting.
How Long to Exercise: Work toward 30 minutes a session. You should build up gradually to this level. There is nothing magical about 30 minutes. If you feel like walking 45 to 60 minutes, go ahead. Just be sure to listen to your body as to when you should stop exercising.
How Often to Exercise: Exercise at least three days a week. These should be non-consecutive days, for example, Monday, Wednesday and Friday. Three days a week is the minimum requirement to achieve the benefits of your exercise.
How Hard to Work While Exercising: This is the most difficult to talk about without knowing your own exercise capacity. Usually, the following ideas are helpful:
- Your breathing should not be so hard that you cannot talk with someone exercising with you. You should feel completely normal within one hour after exercising.
- You should not feel so much muscle soreness that it keeps you from exercising the next session.
- The intensity should be a “comfortable push” level.
- Start out slowly each session to warm up, then pick up your pace, then slow down again when you are about to finish.
The most important thing is to start slowly and progress gradually, allowing your body to adapt to the increased levels of activity.
When should I exercise? Try to schedule your exercise into your normal day. Here are some ideas about when to exercise:
- Wait one hour after a large meal
- Avoid the very hot times of the day
- Morning or evening seems to be the best time for exercising
- Do not exercise less than an hour before bedtime
When should I stop exercising? For both CKD and non-CKD patients
- If you are short of breath
- If you feel chest pain
- If you feel irregular or rapid heart beats
- If you feel sick to your stomach
- If you get leg cramps
- If you feel dizzy or light-headed.
Specifically for CKD patients…Are there any times when I should not exercise?
- Yes. You should not exercise without talking with your doctor if any of the following occurs:
- You have a fever
- You have changed your dialysis schedule
- You have changed your medicine schedule
- Your physical condition has changed
- You have eaten too much
- The weather is very hot and humid, unless you exercise in an air-conditioned place
- You have joint or bone problems that become worse with exercise
- If you stop exercising for any of these reasons, speak to your doctor before beginning again.
And finally when it comes to Nutrition:
Make healthy or healthier food choices
- Cook with a mix of spices instead of salt.
- Choose veggie toppings such as spinach, broccoli, and peppers for your pizza.
- Try baking or broiling meat, chicken, and fish instead of frying.
- Serve foods without gravy or added fats.
- Try to choose foods with little or no added sugar.
- Eat foods made from whole grains—such as whole wheat, brown rice, oats, and whole-grain corn—every day. Use whole-grain bread for toast and sandwiches; substitute brown rice for white rice for home-cooked meals and when dining out.
- Read food labels. Choose foods low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.
- Slow down at snack time. Eating a bag of low-fat popcorn takes longer than eating a slice of cake. Peel and eat an orange instead of drinking orange juice.
- Try keeping a written record of what you eat for a week. It can help you see when you tend to overeat or eat foods high in fat or calories.
Limit alcohol
Drink alcohol only in moderation: no more than one drink per day if you are a woman, and no more than two if you are a man. Drinking too much alcohol can damage the liver, heart, and brain and cause serious health problems.