Moving Forward: Exercise While on Dialysis

If you’re on dialysis, you might feel like exercise is out of reach. With treatment schedules, fatigue, side effects, and other demands, it can seem too much. But many studies show that exercise is not only possible, it’s very beneficial. With the right plan and supports, you can safely build movement into your life and improve how you feel, physically and emotionally.

Why Exercise Matters for Dialysis Patients

Here are some of the key benefits that research has found for people doing dialysis who add exercise into their routine:

• Improved physical performance & strength. Exercise training helps maintain or increase muscle mass, strength, and endurance.
• Better cardiovascular health. Dialysis patients often face high cardiovascular risk. Exercise can help reduce arterial stiffness, improve blood pressure, and support better circulatory function.
• Higher quality of life. Many patients report improved mood, less fatigue, more ability to do daily tasks, and an overall sense of well-being.
• Safety when done right. When tailored to your physical condition and done under guidance, exercise for patients with chronic kidney disease (CKD) including those on dialysis is generally safe. Few serious adverse events are reported in well-supervised programs.

What the Guidelines Say

Here’s what recent consensus and clinical practice guidance recommend, to help you and your care team plan exercise:

• Moderate-intensity aerobic activity for dialysis patients is encouraged. Aim for something in the order of 150 minutes per week (or less, depending on tolerance), or an equivalent mix of aerobic + more vigorous activity if you can.
• Include resistance (strength) training: exercises that help build or maintain muscle strength.
• Tailor intensity, frequency, and type to what your body can handle, gradually increasing as tolerated. Don’t overdo it; starting slow is important.
• Use “intradialytic” periods (while you are undergoing hemodialysis) when possible, for some exercises. For example, light leg or arm exercises during the session. These help make use of treatment time and have been shown to improve outcomes (e.g. arterial stiffness, performance, composition).

What Kinds of Exercise Are Helpful

Here are types of exercise you might include, depending on your health status, preferences, and resources:

Practical Tips: How to Get Started and Stay With It

These are patient-centered suggestions, based on evidence + what dialysis networks / facilities can often support:

1. Check with your care team first. Talk with your nephrologist, dialysis nurse, or your physical therapist if you have one. Make sure your health is stable, and there are no contraindications. They can help set safe limits.
2. Start small. Even short, gentle movements help. For example, do a few minutes of exercise during dialysis or take short walks on days off. Gradually build up.
3. Use dialysis time if possible (“intradialytic” exercise). Some centers offer or allow light exercise during your dialysis session (leg pedals, arm movements, as long as your keep your vascular access still during treatment.). This can maximize your free time and improve outcomes.
4. Make a regular schedule. Set times that work with your treatments and energy levels. You might do lighter or more rest on treatment days and more activity on non-treatment days.
5. Listen to your body. If you feel dizzy, have chest pain, excessive shortness of breath, swelling, or other warning symptoms, stop the exercise and notify your medical team.
6. Stay consistent, not perfect. It’s more helpful to do moderate exercise regularly than to push hard once and then stop. Consistency builds benefit over time.
7. Seek support. Use resources: physical therapists, exercise programs at your dialysis center, rehabilitation services, kidney patient support groups. Sometimes peer support helps with motivation.

What Qsource ESRD Networks Offers and How We Can Help

At Qsource, we’re focused on helping patients not just survive, but thrive. Here are ways we support exercise efforts for dialysis patients:

• We provide resources to dialysis facilities and patients to promote exercise for patients.
• We provide education materials (posters, pamphlets, FAQs) to patients and staff about the benefits and safety of exercise.
• We encourage care teams to include exercise planning into your individualized care plan, asking about what you like, what’s possible, and what supports you need.

Things to Think About / Plan For

Before and as you increase activity, some things to consider to make it safer and more helpful:

• Hydration and fluid balance: Avoid dehydration, but also follow your fluid restrictions. After dialysis you may feel fatigued or low on energy.
• Timing: If you exercise on dialysis days, it may be best during or right after (if recommended), or spacing out rest periods. Non-treatment days may allow for more energy.
• Nutrition: Good protein intake and nutrition are important to support muscle health. Exercise without proper nutrition may lead to muscle wasting.
• Comorbidities: Heart disease, diabetes, bone/joint issues, etc., can influence what kind of exercise is safe or possible.
• Weather, accessibility: If you’re doing walking or outdoor exercise, think about safe routes, weather, support, transport.

Exercise isn’t just a nice extra, it’s a powerful part of caring for yourself with ESRD. It can help you feel stronger, improve heart health, ease fatigue, and make everyday tasks easier. It does take planning, listening to your body, and getting support, but many patients who make room for activity, even small amounts, see real improvements.