This document discusses the benefits of exercise for renal patients. It outlines that exercise can increase endurance, strength, flexibility, and energy while improving mood, sleep, blood pressure, blood sugar levels, cholesterol, heart health, and microcirculation. The document provides guidance on developing an exercise routine based on frequency, intensity, type of activity, and time (FITT principle). It also offers exercise recommendations and safety tips for different types of renal patients, including those undergoing hemodialysis, peritoneal dialysis, and transplant. Additional resources for exercise are also provided.

1. Exercise: The Wonder Drug
Exercise Essentials for All
Dan Bayliss, MS CES
Clinical Exercise Physiologist
University of Virginia Renal
Services
University of Virginia Medical
Center
Charlottesville, Virginia

2. “Lack of activity destroys the
good condition of every human
being, while movement and
methodical physical exercise
save it and preserve it.”
~Plato

4. Introduction
• Benefits of Exercise
• Physical activity vs. Exercise
• When Not To Exercise
• How To Get Started
• Exercise Components
• Hemo vs. Peritoneal vs. Transplant
• Helpful Hints
• Additional Resources

5. Exercise?? Are you Kidding??
• You can do it!!
• Activity levels and chronic disease
• Does exercise/physical activity help?

6. Benefits of Exercise for Renal
Patients
• Increased endurance
• Increased strength
• Increased flexibility
• Increased energy
• Helps lose or maintain weight
• Improves feelings of depression
• Improves sleep!!
• Improves blood pressure

7. Benefits cont.
• Stabilizes blood sugar levels
• Strengthens your heart
• Improves cholesterol levels
• Improves microcirculation
• Reduces the risk for heart disease

8. Physical Activity vs. Exercise
• Physical Activity, defined
by the American College of
Sports Medicine (ACSM) as
“any bodily movement that
is produced by the
contraction of skeletal
muscles and increases
energy expenditure.”
• In other words, get up and
move!!

9. Exercise vs. Physical Activity cont.
• Exercise is defined as “a subclass of
physical activity, planned structured, and
repetitive bodily movement done to
improve or maintain one or more
components of physical fitness.”
• In other words, going for a walk or going to
the gym and working on cardio machines
or even taking a pool class.

11. When Not To Exercise
• Body temperature >101.0 degrees (38.3
degrees C)
• Missed more than one treatment
• Newly undiagnosed illness
• Pain
• Not feeling well
• Blood Pressure <200/100
• Unstable sugar levels

12. SYMPTOMS THAT SHOULD
BE REPORTED TO YOUR MD
• Pain or pressure in chest, neck or jaw
• Excessive fatigue, not related to lack of
sleep
• Unusual shortness of breath
• Dizziness or lightheadedness during or
after exercise
• Persistent rapid or irregular heart rate
during or after exercise

13. How to Get Started
The “FITT” Principle
• FREQUENCY (days per week)
• INTENSITY (how hard)
• TYPE of Activity
• Time (how long to go)

14. FREQUENCY
• Walk around your block once or twice a
week
• Community program
• Senior recreation program
• Start with 5 or 10 min, or what you can
tolerate
• Add 1-2 min every week
• Goal duration should be 20-60 min

15. INTENSITY
Go at your own pace
• Talk Test
– Exercise at conversation level
– If you’re short of breath, slow down
• Rating of Perceived Exertion (RPE)
• Listen to your body!!

16. RPE Scale

17. TYPE OF EXERCISE
• Endurance Exercise
• Anything that involves working your arms
and legs
• Continuous, repetitive, structured activities
– Walking, cycling, dancing, swimming, stair
climbing
• Warm-up/ Cool down

18. TIME
• Start with what you can tolerate
• Walking
– add 1-2 min
• Stair climbing
– Add 1-2 steps per week
• Work towards 30-60 min most days of the
week
• The more you do, the stronger you’ll get!!!
• YOU CAN DO IT!!

19. Strengthening Exercise
Helps improve or maintain strength
• AT LEAST 2x/week
• Hand weights, leg weights, resistance
bands, milk jugs
• Slow and easy progression
• Lift 8-12 times
• 8-10 different exercises
• Take a break (1 set)
• Repeat

20. Flexibility Exercise
• Helps prevent joints from becoming stiff
and painful.
• Types of flexibility exercises:
– Stretching
– Yoga
– Chair stretches

21. Outpatient Hemodialysis
• UVA unique to outpatient exercise
• HD patients tend to be less active
• Strengthening/flexibility exercise
recommended
• Patients usually sit for 2-4 hours, what else
do you have to do?
• Make the commitment to yourself
• Consider it “gym time”
• Exercises should be done within the first
hour of treatment

22. Peritoneal Dialysis
• Exercise in the middle of dialysis
exchange and before adding the new
dialysis fluid
– Allows less pressure on the
catheter
– Reduces the risk of hernias and
catheter leaks
• Keep catheter clean

23. Peritoneal Dialysis cont.
• Tips to keep in mind:
• No full sit-ups, try curl-ups or “crunches”

24. Peritoneal Dialysis cont.
• Cycling
– Keep bag away from pedals
• Swimming
– Sea/pond water vs. chlorinated
water

25. Transplant
• Benefits include:
– Weight management
– Regaining physical function
– Maintain muscle mass
– Other benefits similar to Hemodialysis
patients
– recovery from surgery
• Speak to your MD before starting
• Walking is recommended immediately
post transplant

26. Transplant cont.
• NBA stars Alonzo Mourning and Sean
Elliot

27. Transplant Games
• Transplant
games
• Sponsored by
NKF

28. Helpful Hints
• Talk to your MD before starting an
exercise program!
• Keep a log
• Start slow, results take time
• Get other family members involved
• Bound to wheelchair?
• Physical Therapy/Cardiac Rehabilitation
• Make physical activity a priority in your life!
• It takes time but it also makes time!!

29. Additional Resources
• www.lifeoptions.org
– Exercise: A Guide for People on
Dialysis
• www.smallstep.gov
• www.kidney.org
– Staying Fit with Kidney Disease
– Transplant Games

30. Renal
Rehab
Resource
Center
www.lifeoptions.org
(patients >
free download
materials)
1-800-468-7777

31. So whatever happens in Vegas,
should NOT stay in Vegas when
it comes to exercise and physical
activity!!

32. Surgeon General’s Warning:
PHYSICAL INACTIVITY MAY
BE HAZARDOUS TO YOUR
HEALTH
Patricia Painter, Ph.D.