Chronic Kidney Disease | Sakra World Hospital
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Chronic kidney disease (CKD) worldwide is rising and becoming a priority public health problem. The progression of CKD causes functional limitation and severe disability with poor quality of life. Clinicians should counsel patients with CKD including frail elder people to increase physical activity levels.

Patients receiving haemodialysis have a considerably lower exercise tolerance, functional capacity, and more muscle wasting than healthy subjects or patients with less severe CKD. Exercise training or comprehensive multi-dimensional strategy and goal-oriented intervention should be provided in end stage kidney disease/ dialysis patients.

Several causes can contribute to functional limitations  in these subjects including anemia, malnutrition, lower muscle strength, metabolic disturbances resulting in reduction exercise tolerance, independence and ability to perform activities of daily living

Low levels of physical activity and poor physical functioning are strongly associated with mortality and poor clinical outcomes in these patients, regardless of treatment. 

Regular exercisers have a better quality of life, physical functioning, sleep quality scores, report fewer physical activity limitations.

Exercise training may be delivered in non-dialysis time, either as outpatients or at home, and also during dialysis, termed intradialytic exercise.

It should be emphasized that the most frail and incapacitated patients are probably those most in need of physical rehabilitation as a part of their clinical care.

Therefore, various exercise programs, such as aerobic exercise, resistance exercise, combined aerobic and resistance exercise, and passive exercise including electrical stimulation have been developed for hemodialysis patients. intradialytic exercise programs are superior to interdialytic exercise programs in terms of a lower dropout rate. In addition, intradialytic exercise can be safely done in the first 2 hours of dialysis without cardiac decompensation.

In conclusion, exercise or regular physical activities should be mandatory, not optional, in patients with end-stage kidney disease. However, despite the many beneficial effects of exercise in them, exercise programs are still not a part of routine clinical practice in many centers. However, they need to be individualized. for elderly patients and patients with comorbid conditions.

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Dr. Sushma Rani Raju

Senior Consultant - Nephrology

Dr. Gowrugari Venu Madhav

Senior Consultant Nephrology


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