One way to maintain good health and weight is through physical activity. However, patients with chronic kidney disease (CKD) often expect that they can do only limited movement because of their condition. If you are not currently working out, but are physically capable, you may be able to start an exercise for CKD workout program.

As always, consult with your doctor before starting out or continuing any exercise routine that you’ve been doing prior to being diagnosed with  CKD.  This article will discuss the importance of physical activity and what exercises you can do as CKD patients. 

How can exercise help in your CKD?

Just like any healthy average individual, physical activity can also help improve CKD patients' health conditions. Nephrologists of the medical community believe that CKD patients should engage in regular exercise to improve overall health. Regular exercise can improve blood circulation, strengthen muscles, joints, bones, and improve balance and coordination as we age. Furthermore, it can help reduce the risk of developing hypertension, heart problems, diabetes, obesity, dementia, premature death from a sedentary lifestyle. 

In a study conducted in 2019, exercise therapy for non-CKD patients is being studied as a potential strategy to improve kidney function and the ability of the kidney to filter wastes. It is also being seen as a low-cost and convenient strategy for non-dialysis CKD patients. 

How can you stay safe while exercising?  

You need to check in with your doctor first before starting any exercise program. Your healthcare provider will recommend a routine that is suitable for your condition. 

When starting out a workout program, you will need to look into these three things:

1) Frequency & Length of your exercise

In a journal published by the National Kidney Foundation, it is suggested that you should start slow and work up your pace until you are comfortable. For example, CKD patients may begin three times a week on non-consecutive days with 30-45 minutes a day of exercise. Then slowly increase the frequency to five times a week, 30 minutes a day. 

2) Type of Exercise 

When we talk about exercise, some may think that you can only do it in the gym, but your home can be the perfect spot for exercise routines. According to the National Kidney Foundation, structured activities like aerobic, strengthening, and flexibility activities can be done by individuals with CKD. You can do all of these three inside the comfort of your own home. Let's discuss them one by one.

 - Flexibility Exercises for CKD

First, we have flexibility workouts that involve the ability of your joint to maintain the movement needed to perform physical activity. Flexibility workouts can help lessen your risk of injury in performing exercises, and examples are basic stretching, yoga, and Tai Chi. 

Here is a sample warm-up for your shoulders and legs.

Shoulder Rotations: 

• Step 1: While standing or sitting, move the top of your right shoulder forward in a circular motion for 15 to 30 seconds. 
• Step 2: Repeat with your left shoulder.

Leg Stretches: 

• Step 1: Lay on your back and bend your right leg and keep your left leg straight.
• Step 2: Place both of your hands behind your right leg, then pull your thigh toward your chest. Hold this position for 15 to 30 seconds. 
• Step 3: Repeat with your left leg.

 - Aerobic Exercises for CKD 

Aerobic exercises include activities that require the use of large amounts of oxygen. Some examples include walking, jogging, stair climbing, swimming, gardening, dancing, and bicycling.

Here is a sample walking program that you can do: 

• Step 1: Begin by walking slowly but steadily for 10 minutes 5 days a week. 
• Step 2: Once comfortable walking 10 minutes daily, then increase to 20 minutes every other day at a brisk pace. 
• Step 3: For one month, increase your time to 30 minutes every other day. 
• Step 4: Then, after one month, you may try walking for 30 minutes 5 times a week. At this point, you may already be comfortable having long walks, and continuation of this may help improve your health.

 - Strength Exercises for CKD 

On the other hand, strengthening exercises involves the use of muscles to perform activities. Examples are lifting weights by using dumbbells or kettlebells, resistance bands, and medicine balls. Pilates is another form of strengthening exercise.

Here is a simple strength program you can try at home:

Toe Raises:

• Step 1: Stand straight with your hands on a counter or rail for support. Slowly raise your heels off the floor and count to two. 
• Step 2: Then lower your heels back down to the floor. Repeat 8 to 12 times.

Leg Lifts:

• Step 1: Sit in a chair with your back upright. Then bend your knees and lay your feet flat on the floor. Next, lower your right leg to the starting position. Afterward, begin to lift and straighten your right leg and hold for a few seconds.
• Step 2: Repeat this with your left leg and perform exercise 8 to 12 times with each leg.

You may also check this link by the National Kidney Foundation for more sample exercise routines that you can do at home. 

Remember that you should always listen to your body. If you develop any of these problems, stop exercising, rest, or, if needed, seek medical help. 

• Starting to feel muscle cramps or joint pain
• Feeling nauseous or having the urge to vomit
• Feeling pain in the upper part of your body. This includes your face and jaw
• Starting to have trouble seeing, speaking, or trouble swallowing
• Beginning to have shortness of breath
• Feeling of lightheadedness
• Having a headache or feeling dizzy 
• Feeling of sudden weakness in your arms or legs

3) Fluid Intake

Exercising may cause you to perspire heavily, so this may have CKD patients thinking if you need to drink more water. You may need to replace lost fluid in situations like this, so coordinating with your renal dietitian is essential. 

Suppose you are urinating less and perspiring more. In that case, your dietitian may increase your fluid intake, especially if you are consistently doing exercise routines. It is vital that you explain the frequency of your exercise routine to help your dietitian identify your required fluid intake. 

Does working out allow you to eat restricted foods in your CKD diet? 

Exercise and proper diet work hand in hand in improving the body's overall health and quality of life. However, being consistent in exercising does not merit an excuse to abandon the renal diet. In case your appetite increases as you progress into your workout, you can talk to your renal dietitian, so they can assess the necessary adjustment to your meal plan, to accommodate your dietary requirement.

Eating restricted foods, without conscious limitation, can threaten a CKD patient's health and worsen the kidney's condition. Therefore, it is crucial that you know which food items and nutrients you should limit, so that your efforts to improve your health through exercise will not be wasted. 

Exercise for CKD Workout Intensity

The intensity of your workout depends on plenty of factors. Nevertheless, you should consider the following:

• Muscle soreness after an exercise is normal, but it shouldn’t keep you from doing the next session.
• Your breathing shouldn’t be too difficult that you find it hard to speak.
• Consider getting a workout buddy-- makes working out much more fun
• Build up your pace

Besides the intensity, you must also consider the schedule of your workout. Wait an hour or two after a large meal before getting active. Don’t work out during the peak temperatures of the day, as this will put extra stress on your body. Stop exercising immediately if you feel exhausted, breathless, have chest pain, or have irregular heartbeats. Talk to your doctor if these conditions persist. 

Bottomline

Exercise is a great way of improving your overall health and reducing your risk of complications including hypertension, diabetes, obesity, and CKD progression. Working out doesn’t have to be rigid, intense, or too athletic. No matter which level of fitness you are in, you can build your strength and stamina by starting light and slow.

With exercise, you can improve muscle strength, blood pressure control, sleep quality, and body weight control. Making it part of your daily habit while enjoying the routines will make it feel less like a chore-- much like eating and sleeping. Do not be afraid to seek encouragement from your circle of support and, when in doubt, ask for professional advice from your healthcare team.