Exercise during dialysis: an option you should really consider

Many people believe that dialysis is the end of many aspects of life, and it is not. Thousands of people manage to continue with their normal lives. These people suffer a permanent condition and need particular care, though, but it is possible to live with dialysis. An evidence of this is the wide number of athletes who have shown the world that it is possible to get ahead in these harsh conditions. Sean Elliot, Ed Hearn, Paul Hutchins, Donald Jones, Chris Kemoeatu … they know what you have been going through, and they have found ways to get ahead with sports. In addition, they have also helped the medical community a bit. It is known that exercising is very helpful during dialysis, which was previously considered unthinkable, both for patients and doctors.

In this post, we will talk about exercise during dialysis treatment. In addition to the benefits, what exercises could you do to improve your health conditions?

According to an article from the Journal of Physical Therapy Science (2017,) dialysis patients who exercise daily have a better quality of life and suffer less risk of getting worse and dying. Actually, exercise favors circulation and oxygen levels in the blood, helps food to be processed better, improves the mood of patients, strengthens the immune system, benefits the quality of sleep, and, above all, increases the effectiveness of dialysis because the filtering of blood is much higher.

This knowledge is not new. In fact, more than three decades, it is already known that exercise brings great benefits for patients with renal failure. What has happened is that the knowledge about this was not extensively widespread during all these years. Now it’s a trend, and, by the way, most doctors advise patients with kidney failure to exercise on a daily basis (including elderly patients.)

The main concern that arises, especially in the case of athletes, is related to food. An athlete needs a greater amount of energy than a sedentary person, and the problem is that some of the foods that provide this energy may be counterproductive for a kidney failure patient. Meat, for example. An athlete needs a greater amount of protein, but patients with kidney problems should be very careful with purines. For this reason, it is highly advisable to listen to the considerations of dietitians in these cases.

So, what exercises are recommendable, then?

Along with any exercise of your choice, from basketball to yoga, and snowboarding, these indoor and outdoor exercises could be an excellent alternative for you:


Aerobic exercise, unlike others, is not designed to beautify muscles, but to strengthen the cardiovascular system. Unlike most gym routines, these exercises do not seek to develop the strength of the muscles, but rather their resistance. These are the exercises that consume more body fat and which provide a greater amount of oxygen to the bloodstream. An additional benefit of aerobics is that they help the body to release a lot of endorphins, which is quite positive for patients with renal failure since depression is quite common in these cases.

Read also: Dialysis most common complications, by Joe Cosgrove

Tai Chi and Martial Arts

Strength exercises are also very beneficial. For this reason, if you want to combine aerobic exercise with strength exercises, martial arts are a must. Besides that they will help you to attain discipline, you will have belt-challenges to stay motivated. Martial arts usually consist of really complete exercises. Kung-Fu, Taekwondo, Karate, and Jiu-Jitsu: all of them are wonderful.

However, if you consider yourself a less explosive person, Tai Chi is a good option. Although Tai Chi began as an attack and defense system in the past, it gradually became a meditation in motion which is tremendously beneficial for the health of the body and the mind.



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Swimming is one of the most recommended exercises by doctors, and for several reasons. One of them is that in the cold water of a swimming pool, your muscles will work with more effort and this allows not only to burn more than five hundred calories per session but to strengthen the muscles and the immune system. Swimming delays aging improves the lung capacity of people (a regular session of swimming is an excellent aerobic exercise) and strengthens the lung capacity which translates into higher levels of oxygen.

Wim Hof Method

You probably do not know the ‘Iceman,’ Wim Hof, the creator of a very interesting therapy that has broken paradigms in medical science for its interesting findings. Wim Hof is able to withstand ice-cold temperatures for ninety minutes, to run a marathon in a desert without drinking a drop of water, and to keep his breath for ten minutes under the water. He has achieved it with a lot of work, and now he teaches in seminars and apps. Although it sounds fake to skeptics, the Wim Hof method not only strengthens the immune system in a very powerful way but also helps patients to control their anxiety. The system consists of a series of breaths repetitions, flexibility exercises, and icy water dives (just judge yourself.)

* Featured Image courtesy of Pixabay at Pexels.com


Dialysis most common complications

The procedure known as dialysis has been created so that the elimination of toxins and the excess of liquids in the body is possible; a function that, in healthy patients, carries out the renal system (kidneys, in particular.) Even though dialysis is so far the best-known option to treat kidney disease, and despite the fact that the biomedical technology makes all its efforts in considerably improving this system, it is still not possible to execute processes of error-proof dialysis. Unfortunately, complications can occur during the process, which can even negatively affect the health condition of patients. In this post, we will talk about the most frequent complications that can occur during dialysis.

In extracorporeal dialysis, the processes in which blood is removed from the body, complications are not as common. However, it is possible that an arteriovenous fistula infection may occur. Since the fistula is punctured three to four times a week to purify the blood, the risk of infection by bacteria in the puncture site is high. In addition, there is the possibility that thrombi form that obstructs the blood vessel and renders it unusable for dialysis. However, as a general rule, a surgical intervention allows the thrombus to be removed and the fistula to be unblocked.

In peritoneal dialysis, in which the blood is purified inside the body, there is a risk of inflammation of the peritoneum. Bacteria enter the peritoneal cavity through the catheter and cause a painful infection that, under certain circumstances, may endanger the life of patients. Normally, this inflammation responds well to treatment with antibiotics, but sometimes it is not that simple.

People with severe kidney disorders and kidney failure must pay great attention to their diet since many of the complications suffered by dialysis patients are related to food. Since the kidneys are not able to carry out their function of purification and excretion, in many cases those affected can only drink a limited amount of liquid. In addition, they must be careful with the contribution of protein and potassium, since an excess of these substances may lead to serious metabolic disorders in dialysis patients.

Read also: Baxter ShareSource System: A New Dialysis Option for You, by Joe Cosgrove

People with impaired renal function often have a high concentration of phosphate in the blood which may cause damage to blood vessels, such as arteriosclerosis. When the concentration of this is too high, despite having a low phosphate diet, so-called phosphate binders are helpful, they bind to the phosphate ingested with food in the gastrointestinal tract and are subsequently excreted. There are various types of phosphate binders, for example, containing aluminum or calcium, or free of both, which effectively improve the altered balance of minerals in dialysis patients. According to recent scientific findings, it seems that calcium-free phosphate binders are the ones that cause fewer side effects. Nowadays, the use of phosphate binders with aluminum content is no longer recommended due to the adverse effects that they may cause. A treatment with this type of medicine – for many years – may produce an accumulation of aluminum in the brain and bones which leads to worsening brain function and movement limitations.

In order to prevent possible infections of hepatitis B and C, and even HIV, through dialysis, the medical centers in which this treatment is carried out meet the strictest hygienic standards for the cleaning of dialysis machines. People suffering from these type of infections are treated in their own dialysis machines which are not used with any other patients. In addition, active vaccination against hepatitis B is recommended to all dialysis patients.


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There are other complications related to hemodialysis. Intradialytic arterial hypertension is less frequent than arterial hypotension, but it has relevant prognostic implications. Fever and chills in patients on hemodialysis should be attributed to endovascular infections, especially in those who have vascular access through a high-flow venous catheter. Likewise, fever at the end of the hemodialysis treatment is suggestive of endovascular infection.

On the other hand, hypervolemia is a complication that occurs regularly. This happens when the patient consumes more fluid than the one he manages to eliminate thanks to dialysis. Hypervolemia can also develop in response to sodium retention in the body due to impaired electrolyte excretion. In nephrological practice, hypervolemia due to sodium retention is observed in acute ophthalmic syndrome, in the oliguric phase of acute renal failure, due to the consumption of large amounts of fluid and obstruction of the urinary tract with volume-dependent hypertension. This problem usually leads to weight gain, and, when not treated in time, can be deadly because heart failure may occur.

Taking into account that during the last decades there has been an increase in cases of renal replacement therapy for different diseases, and, additionally, considering the increase in infections that are difficult to treat, mainly due to the widespread abuse of analgesics by professionals and patients who self-medicate (and who do not know how to differentiate a virus from a bacterial infection,) it is vital to know the different treatment modalities in these patients as well as the complications that can occur in practice.

Recommended: Infections in Patients Undergoing Chronic Dialysis

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Some of the trends we can expect for dealing with chronic kidney disease

It’s sad but true: Chronic kidney disease progressively increases. In fact, in the registers of all countries, there is a constant increase in the population of patients who need dialysis as a substitute for their useless kidneys. The magnitude of this problem is serious when it comes to social health and, therefore, the finances of society. The reasons for this high mortality are indeed diverse but a significant factor here is the age of patients (considering that the population of old people is growing,) as well as a restoration with any kind of dialysis treatments of only fifteen to twenty milligrams per minute of renal function. Despite the advances that have been made in hemodialysis and peritoneal dialysis, there has not really been a clear improvement in the progress of patients’ conditions.

Considering the few advances in this field, but the accelerated pace of technology in general, the question that arises is very simple: What trends in terms of dialysis can we expect to treat (and, perhaps, eradicate) chronic kidney disease?

The conditions of patients on hemodialysis, in general, represents a tremendous sacrifice for relatives and close people, mostly because of all the physical and emotional suffering they experience and the constant traveling to dialysis centers three times (or more) per week. In addition, the amount of deadly cases, not too different than those of metastatic carcinoma of the breast, to carcinoma of the colon or to that of prostate cancer, this forces the medical community to move towards other ways to solve this problem.

Although there have been many cases of progress in the health of patients thanks to the effective implementation of traditional methods of dialysis, especially in what has to do with the quality of life of patients, dialysis is not it ceases to be a control procedure, which only keeps an impossible problem at bay. This is what has set in motion the gears of science to find definitive solutions.

Read also: Dialysis: Almost 70 decades of hard work and progress, by Joe Cosgrove

It is undeniable that peritoneal dialysis is a very practical method for the life of patients since they do not depend so much on contact with professionals, as well as on the displacement to dialysis centers. In particular, peritoneal dialysis, which has been working with intelligent mechanisms connected to the Internet, is one of the most recent advances and the most beneficial for the work of medical science, thanks to the constant monitoring, and, consequently, to the constant production of data, research in this field can go a long way to find definitive solutions, in which dialysis as such is no longer necessary.

On the other hand, there is another effective method. Online hemodiafiltration it’s a new dialysis system that allows a greater filtration than what is usually achieved with conventional hemodialysis. It is one of the techniques that aroused greater interest in patients nowadays, and the use of it will surely grow. It is a modality of dialysis that maintains the diffusion levels of hemodialysis by increasing the convection, so that, by infusing a greater quantity of water, a higher level of solutes can be carried from the blood to the dialysis fluid. The clearance that is obtained is greater.

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In hemodiafiltration, it is necessary to infuse a liquid of greater purity than that used for conventional modalities. This leads to using machines with very clean filters that, of course, are much more expensive. Although conventional hemodialysis guarantees very good results in the short term, in the long term it is a difficult experience for both patients and people around them. So this can be an excellent alternative.

However, hemodiafiltration online is not yet a widespread technique, and to make it massive is not a simple matter. Because there is still no study that states with total certainty that this option has clear advantages over conventional hemodialysis, there is still not much support from the governments of many countries. Although it is a technique that has shown advantages in some fields, It is very risky to consider that, definitely, it is the perfect replacement for the other types of dialysis.

The future of dialysis does not have much to do with the reduction of filtering times to which patients must submit. The current trend is to encourage techniques such as peritoneal dialysis, which dialyze more hours and more frequently since it is the way of working more similar to that of the kidney.

Embryonic stem cells could be an important trend too. These are undifferentiated pluripotent cells, isolated from the inner layer of the blastocyst, have the ability to differentiate into cells of different types: Mesodermal, endodermal, and ectodermal, depending on the culture conditions. It is, therefore, a type of cells that have a potential possibility of tissue regeneration.

It is necessary to be optimistic and continue investigating. If dealing with chronic kidney disease is a medical priority in several countries, the future of patients will be promising.

Recommended: Changes in the worldwide epidemiology of peritoneal dialysis

* Featured Image courtesy of scribbletaylor at Flickr.com