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Hemodialysis 101 | How Kidney Patients Can Exercise Safely
Hemodialysis significantly extends the lives of kidney patients, but comorbidities such as anemia and malnutrition can lead to decreased physical function and quality of life. Exercise can help kidney patients improve these "predicaments." Previous research indicates that moderate exercise can enhance dialysis adequacy, improve quality of life, and alleviate depression, among other benefits.
The KDIGO 2012 Clinical Practice Guideline for the evaluation and management of chronic kidney disease suggests that exercise is a cornerstone of dialysis treatment. It is recommended that CKD patients engage in exercise that is compatible with their cardiovascular function and tolerance.
Benefits of Exercise
1. Improves Cardiopulmonary Endurance:
Enhances lung ventilation efficiency and oxygen utilization, improving cardiopulmonary function.
2. Enhances Sleep Quality:
Reduces nighttime awakenings and decreases patient fatigue.
3. Improves Physical Function:
Prevents or treats complications such as muscle atrophy and promotes walking ability.
4. Increases Dialysis Adequacy:
Exercise during dialysis can speed up the removal of metabolic waste from the body.
5. Reduces Mortality Risk:
Slows heart rate, reduces cardiac oxygen consumption, and decreases the incidence of cardiovascular complications.
6. Regulates Blood Pressure:
Improves the viscosity of whole blood and plasma, increases vascular permeability, and clears blood vessels.
Exercise Content
Exercise can be performed during dialysis or outside of dialysis sessions. Warm-up and cool-down exercises of no less than 5 minutes should be done before and after the main exercise.
· During Dialysis Exercise: Should be performed between 30 minutes to 2 hours after dialysis starts, for at least 30 minutes each session.
· Non-Dialysis Exercise: Should be done 1 to 2 hours before each dialysis session, with total exercise time between 30 to 60 minutes.
Exercise Intensity
The duration, frequency, and intensity of exercise should be gradually adjusted until the desired exercise goals are achieved.
Exercise Frequency
Exercise should be regular and planned, at least three times a week, and continued for at least four months.
Exercise Guidance and Supervision
The exercise plan for patients should be adjusted according to medical advice and individual patient conditions, considering factors such as exercise type, intensity, duration, dialysis environment, and patient health status.
Exercise during dialysis should be conducted under the guidance and supervision of medical staff to achieve the best results.
Types of Exercise
1. During Dialysis:
o Neck Stretching: Sit up straight, gently tilt your head forward, then slowly turn to the left, and then to the right. Hold each direction for a few seconds and breathe correctly.
o Shoulder Rotation: Place your hands by your sides, slowly lift your shoulders and rotate them backward. Then relax your shoulders and rotate them forward. Repeat several times.
o Wrist and Arm Stretching: Extend your hand and arm straight, then gently pull the back of your fingers with the other hand, holding for a few seconds. Repeat the stretch on the palm and wrist side. Repeat several times.
o Waist Twisting: Stand with your feet apart, let your hands hang naturally. Slowly twist your upper body to the left, then to the right. Avoid forceful twisting; keep it comfortable.
o Hip Stretching: Sit in a chair, place one foot on the opposite knee. Lean forward gently until you feel a stretch in the hip and back of the thigh. Hold for a few seconds, then switch legs.
o Thigh Stretching: Stand or sit in a chair, lift one foot, hold the ankle or toes, and slowly stretch the thigh muscle towards the hip. Hold for a few seconds, then switch legs.
2. Outside of Dialysis:
o Mild Aerobic Exercise: Walking, cycling, swimming, dancing, aerobics.
o Light Resistance Training: Dumbbells, water bottles, or medicine balls with resistance bands or light weights. Bodyweight exercises like push-ups, sit-ups, squats, and mountain climbers. Flexible exercises like yoga and Baduanjin.
Headaches can reduce the quality of life for MHD patients, leading to anxiety and depression. Understanding the causes of headaches can help kidney patients better prevent or alleviate them.
In the next issue, we will explore knowledge about hemodialysis. Kidney patients are welcome to bookmark, follow, and share this information. If you have any suggestions or topics of interest, feel free to leave us a message.
Let’s continue learning about hemodialysis in the next issue!
References:
1. Liu Yixiu et al., Meta-analysis of the intervention effect of combined exercise on hemodialysis patients. Chongqing Medicine, 2024-02-22.
2. Zhu Guoying, Application of exercise plans in the nursing of patients with end-stage renal disease undergoing hemodialysis. Chinese Rural Medicine, 2023, 30(24), 65-66.
3. Yu Jie et al., Chronic kidney disease patients should persist in self-management. Family Medicine. Seeking Medical Advice and Medication, 2023, (06), 28-29.
4. Qiao Xianhui, Professional doctors tell you how to carry out rehabilitation exercises during hemodialysis. Proceedings of the Third National Medical Research Forum (III) Yulin Medical Association.
5. Sun Jiajia et al., Summary of the best evidence for exercise during dialysis in maintenance hemodialysis patients. Journal of Nursing, 2022, 37(13), 9-12.
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