Exercising With End-Stage Metabolic Disease: Prescription for Health

American College of Sports Medicine

April 09, 2010


Exercise can be a particularly daunting prospect for individuals with end-stage kidney or liver failure. However, it has been reported that exercise training improves blood pressure control, lipid profiles and overall feelings of well-being in some individuals. Improving your ability to perform low-level activities can mean the difference between continuing to work and live independently and becoming disabled. The key to maximizing the benefits of exercise is to follow a well-designed program that accommodates your specific needs and concerns.

Getting Started

  • Talk with your health care provider before starting an exercise program and ask for specific programming recommendations.

  • Take all medications as recommended by your physician.

  • The goals of your program should be to improve mobility, your ability to perform activities of daily living, and your overall fitness.

  • Choose low-impact activities such as walking, cycling or water exercises, which involve large muscles groups and can be done continuously. Low-intensity, longer-duration workouts are preferred over high-intensity activities.

  • Start with shorter sessions (10 to 15 minutes) and gradually build up to 20 to 60 minutes, four or more days per week.

  • Add high-repetition, low-resistance strength training and range-of-motion stretching exercises two to three times per week.

  • Practice performing daily activities, such as rising from a chair or climbing a flight of stairs.

  • Take frequent breaks during activity if needed. Use the ratings of perceived exertion as well as heart rate to measure the intensity of your workouts.

Exercise Cautions

  • Closely monitor your intensity level and adjust your workouts if you feel fatigued. Gradual progression is essential.

  • Exercise may be less tolerable after dialysis treatment. However, exercise during dialysis is recommended whenever possible.

  • If you experience a medical setback, adjust your program accordingly.

Your exercise program should be designed to maximize the benefits with the fewest risks of aggravating your health or physical condition. Consider contacting a certified health and fitness professional* who can work with you and your health care provider to establish realistic goals and design a safe and effective program that addresses your specific needs.

For more information, visit www.exerciseismedicine.org or e-mail eim@acsm.org.

* If your health care provider has not cleared you for independent physical activity and would like you to be monitored in a hospital setting or a medical fitness facility, you should exercise only under the supervision of a certified professional. The American College of Sports Medicine (ACSM) has two groups of certified fitness professionals that could meet your needs. The ACSM Certified Clinical Exercise Specialist (CES) is certified to support those with heart disease, diabetes and lung disease. The ACSM Registered Clinical Exercise Physiologist (RCEP) is qualified to support patients with a wide range of health challenges. You may locate all ACSM-certified fitness professionals by using the ProFinder at www.acsm.org.

Sources: ACSM’s Guidelines for Exercise Testing and Prescription and other ACSM publications.