Why Kidney Patients Should Exercise Their Right To Exercise!
I could write a book on the excuses people make to avoid exercise. The commonest excuse would de facto become the title of the book and this is, ‘l don’t have the time.’ Of course, I do not buy this excuse because we all have the same 24 hours in a day and it is totally up to us to find time for exercise. The far-reaching benefits of exercise have been discussed and firmly established in medical literature over the decades.
All heart experts universally recommend that people with kidney disease should exercise regularly
Further, the benefits of exercise have been confirmed unequivocally in patients with heart disease, lung disease, cancer, diabetes, and hypertension, to name a few. However, till 2012, the benefits of exercise had not been confirmed in patients with kidney disease. But today, after plenty of research and experimentation, it has been proved that regular exercise benefits people with kidney disease as well! The goals of exercise in patients with kidney disease are threefold:
1. Reduce The Risk Of Heart Disease
Heart disease is the number one killer in patients with kidney disease. This is because the traditional risk factors for heart disease like diabetes, blood pressure, and cholesterol are more common in these patients. Also, non-traditional risk factors like stress, blood vessel damage and inflammation are more prevalent in them. Research has shown that exercises like walking, cycling, elliptical training, swimming, and resistance training modify and ameliorate all these cardiac risk factors.
2. Improve Physical Performance And Functioning
Kidney disease significantly reduces physical performance and function. It is said that in a kidney patient, the ‘get up and go’ instinct that makes us active, just ‘got up and went!’ Thus, patients with kidney disease lack the energy to perform even basic physical activities like housework, shopping and rising from a chair without using their arms.
There are multiple reasons for this physical deconditioning in kidney patients, like low hemoglobin, vitamin D deficiency, high levels of blood acids and toxins. However, studies have shown that moderate degrees of aerobic and resistance exercises increase stamina, muscle strength and muscle bulk in these patients.
3. Slow Down The Progression Of Kidney Disease
Like most chronic diseases, kidney disease is relentless in its progression. Once kidney disease has persisted for more than three months, it becomes irreversible and continues to worsen, no matter how well and carefully it is treated. The only option available then, is to slow down the progression and delay the requirement of dialysis or transplantation.
Currently, the only methods to delay the progression are control of blood sugar, control of blood pressure, diet control infection control and minimization of medications. Fortunately, animal experiments have shown that exercise also slows down kidney disease progression. Though these experiments have not been replicated in humans — no study to date has shown a detrimental effect of exercise on progression of kidney disease. So considering the proven benefits of exercise on other systems, it is reasonable to assume exercise would benefit the kidneys as well.
Safety Of Exercise Among Patients With Kidney Disease
Though regular physical activity is widely recommended for the general population as well as those with kidney disease, there is a risk of sudden heart failure following vigorous physical activity, even in those who are regularly active. However, compared with inactive individuals, active people have a lower risk of heart attacks.
For every athlete who dies on the field or for every gym-enthusiast who dies while exercising in the gym — there are more than a million sedentary people who die due to the complications of lack of exercise.
All heart experts universally recommend that people with kidney disease should exercise regularly, but start with low-intensity exercises which are gradually increased. The only precaution should be to ensure that the blood pressure is below 200/110 mm of Hg and blood sugar is above 100 mg/dl. Pre-exercise testing is not recommended, as the risks of exercise testing are more than the exercise itself!
The Amount Of Exercise Recommended For Patients With Kidney Disease
Moderate intensity aerobic exercise for a minimum of 30 minutes on five days a week or vigorous-intensity aerobic exercise for 20 minutes three times a week is recommended. Nevertheless, the definition of moderate and vigorous-intensity would vary according to age, gender, and basic fitness levels.
In addition, the exercise session should also include muscle-strengthening, flexibility training, and balance exercises. So, today there is a paradigm shift in protecting and mollycoddling patients with kidney disease to encouraging them to be physically active and to exercise their right to exercise.