Anemia is one reason why people with chronic kidney disease (CKD) might feel more tired than a person without CKD. This might lead to a tendency to cut back on physical activity. After time, you might have difficulty climbing a flight of stairs or walking around the block. If this happens to you, your healthcare team can assist you in beginning a physical activity program or can further encourage you if you have already begun a program. Remember, do not start a physical activity program without first consulting your doctor.

Developing and sticking to an exercise program can help you in the following areas:
• Improve physical functioning.
• Increase physical stamina.
• Improve blood pressure control and reduce the risk of coronary artery disease.
• Improve emotional well-being.
• Lower levels of cholesterol and triglycerides.
• Result in a better night’s sleep.
• Better control of body weight.

A Friendly Note:
Exercise is beneficial for everyone – whether or not you have CKD. Because you didn’t exercise before, doesn’t mean you shouldn’t start now. However, be sure to talk to your doctor before starting any exercise program.

I have CKD and I continue to work. How will exercise help me?

Many CKD patients are able to continue working. With any person, it can sometimes be difficult to schedule exercise into a busy work and family schedule. However, this is something you will want to strive to add to your daily routine. Something as simple as walking 20-30 minutes per day will have a remarkably positive effect on your well-being. In addition, maintaining your physical strength, which also helps improve your emotional well-being, is useful in promoting job retention.

Are there things I should know if I have diabetes and want to exercise?

Yes. First, be sure to talk to your doctor about exercising. Changes in your metabolism may change your blood glucose and cause different needs with your medicines. 

General guidelines to keep in mind are:

• Be sure you have good shoes and practice proper foot care.
• To reduce the risk of hypoglycemia, you should exercise 30 to 60 minutes after eating.
• Follow a regular routine of exercising, eating meals and taking medicines.
• Be careful starting a long or strenuous activity such as marathon running, heavy weight-lifting, etc., as these can cause your body to produce adrenaline and other hormones. Such activity may change the effects of insulin and cause blood glucose to rise, thus your insulin needs would need to be changed. Talk to your physician prior to starting such activities.
• The saying, “No pain, no gain,” can be hazardous. Stop any exercise that causes pain.
• Test your blood glucose before and after you exercise. If it is 100 mg/dL or lower before you start exercising, be sure to first eat a snack. If your blood glucose is 300 mg/dL or higher before starting, do not exercise.

Why is it a good idea for me to exercise? I never did it before I had CKD.

Exercise is a very important part of any program to stay healthy.

Heart disease is the major cause of hospitalization and death in kidney disease and dialysis patients. Endurance exercise training, such as running, swimming or bicycling, has been shown to improve HDL cholesterol (good cholesterol) in the general population.

Cardiovascular fitness is a predictor of mortality. Of course, patients who exercise regularly should have their doctor’s approval. Patients with CKD need only to look to the sports pages for inspiration. In 1999, Sean Elliott helped the San Antonio Spurs to win four out of five playoff games over the New York Knicks for the NBA Championship. A few weeks later, he underwent a kidney transplant. It’s evident that he had chronic kidney disease during the most illustrious time in his career. He never missed a game and scored double digits in most games! But you don’t have to be a superstar. Simple activities, such as walking, can be beneficial.

CKD can be associated with muscle wasting, but this may be related to decreased nutrition and inactivity. Although it’s recommended that patients with CKD limit their intake of protein (or at least not increase protein consumption), there is controversy as to how much. In the later stages of CKD, patients lose their appetite and may experience muscle wasting as a secondary complication of decreased kidney function. It has been shown that resistance training (weights and exercise machines) will increase muscle mass and help patients on protein restriction better use what protein they do ingest. But, remember to check with your doctor first.

Above all, exercise makes one feel good. This is true regardless of the underlying condition. Patients with heart failure also benefit from cardiac rehabilitation. In the past, poor nutrition and anemia decreased exercise capacity. Now, we are aware of both of these problems and can focus on avoiding them.

This article was obtained from AAKP’s Kidney Beginnings: A Patient’s Guide To Living With Reduced Kidney Function. To request a copy of this book, call the AAKP National Office at (800) 749-2257.

This article originally appeared in the June/July 2004 issue of Kidney Beginnings: The Magazine, Vol. 3, No. 2.

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