Exercise in the Dialysis Patient

Sustaining a hemodialysis exercise program: a review

This article reviews the literature addressing exercise programs for dialysis patients to identify elements necessary for sustaining exercise programs in this population. Literature searches for publications (January 1980-February 2009) in Medline (OVID), PubMed, CINAHL (EBSCO), EBSCOhost EJS, ProQuest Central, Web of Science, Cochrane Library, Google Scholar, ScienceDirect, SpringerLink (Kluwer), and Wiley Interscience (Blackwell) were performed. Reference lists from relevant articles were hand-searched for further publications. Criteria for inclusion included full-text primary research and review articles focused on exercise for adult hemodialysis patients. One hundred and seventy one publications were found with a primary focus on exercise in hemodialysis. Of these, 28 primary research and 14 review articles addressed one or more aspects of sustainability of hemodialysis exercise programs. Factors contributing to sustainable exercise programs included: dedicated exercise professionals; encouragement to exercise intradialytically; dialysis and medical staff commitment; adequate physical requirements of equipment and space; interesting and stimulating; cost implications need to be addressed; exercise is not for everyone; requires individual prescription; and there is no age barrier to exercise on hemodialysis.

The role of exercise in rehabilitation for patients with end-stage renal disease

End-stage renal disease (ESRD) is a major health problem in the United States. Many patients with ESRD experience a decline in physical functioning as a result of the disease process and its associated sequelae. Cardiovascular changes, anemia, and skeletal muscle weakness contribute significantly to this decreased capacity, leading, in many instances, to a primarily sedentary lifestyle. Studies conducted on the effectiveness of exercise training for patients with ESRD reveal numerous physiological and psychological benefits, particularly when training is continued for several months. However, the number of structured exercise programs available as part of a rehabilitation program for ESRD patients is limited. This article provides an overview of the role of exercise for patients with renal disease, and a case study illustrates how nurses, in collaboration with the interdisciplinary team, can be effective in preventing continued deconditioning and in maintaining a more positive outlook in patients with ESRD.