Kidney, exercise, and your health

Please consult with your physician before starting any new exercise program.

Did you know that September 21-25th is Falls Prevention Awareness Week? Falls are not a normal part of aging.

As we get older, we have a higher risk of falling and having more health-related complications. Consistent exercise can help prevent falls in older adults. So today I’m talking about the kidney-exercise connection and what you need to know when it comes to exercising with chronic kidney disease.

Most people know that exercise is very important for our health. But when it comes to having a chronic health condition like kidney disease, there are risks to consider.

Our kidneys help manage our blood pressure. With kidney damage can come blood pressure control issues. And many people that have kidney disease because of uncontrolled blood pressure. 

We want exercise to help with blood pressure control (it’s been shown that exercise can help lower blood pressure). We don’t want to push so hard that our kidneys get damaged.

Let’s spend some time focusing on what to pay attention to when it comes to your kidney, exercise, and stress management.

How does exercise help me if I have kidney disease?

Exercise is helpful in many ways for the typical person. Many people see some healthy weight loss or body composition changes (lose fat, gain muscle, gain bone strength). Those with blood sugar control issues have seen improvements in insulin levels and tighter blood sugar control. Exercise can help with mental health and prevent depression or anxiety.

If you have kidney disease, there are kidney-specific benefits to exercise! 

We also know that kidney disease often comes with other health issues like diabetes, high blood pressure, depression, and cardiovascular disease. You can see lower blood pressures, lower cholesterol, more muscle function, and better sleep. 

One study found that those with hypertension and chronic kidney disease experienced improvements in their C-reactive protein (a marker of inflammation), improved fasting blood glucose, and an increase in their functional capacity!

There is an association between mental decline and kidney disease. Cognitive function has been shown to improve with exercise. Adding exercise to our routine can lead to a better quality of life as we get older. 

Does exercise help kidney function?

Exercise alone has not been conclusively shown to improve kidney function in studies. However, when pairing exercise with a healthy diet and lifestyle, it is an important factor to having better quality of life.

Can exercise damage kidneys?

There is such a thing as exercising too much. Rhabdomyolysis is the breakdown of muscle. This can happen with intense exercise done repetitively. Rhabdomyolysis – or rhabdo for short – can lead to kidney damage of up to 40% that may or may not be permanent. 

Rhabdomyolysis-induced acute kidney injury needs to be medically addressed immediately- sometimes with temporary dialysis. For the record, this would be considered a severe case and is not commonly seen.

Is walking good for your kidneys?

Walking is one of the best things you can do for your kidney health that isn’t diet-related!

Walking is a low- to moderate exercise and is entirely customizable! So go as far and as long as you like, add hills or stairs if you want, or don’t! You’ll still get benefits from whatever walking you’re able to safely do.

One study that focused on a walking program for those with stage 4 and 5 chronic kidney disease found that people who completed just 1 month of an exercise routine had benefits like improved cardiovascular health and no increase in their blood pressure medications! (This was compared to the other group that did not exercise; they got more blood pressure meds.)

Can I do high intensity exercises?

Also known as high-intensity interval training (HIIT), high intensity exercise is when you work hard for a short period of time, take a break, and then exercise again. 

A study performed on a group of kidney warriors found that high-intensity exercise could be safely done twice a week. Benefits seen in this group included better oxygen capacity of their lungs. More oxygen is good for us and our kidneys!

How should I start exercising if I have kidney disease?

First discuss any exercise plans with your doctor. They will help make sure your exercise program will be helpful and safe.

Types of exercises

There are several different types of exercise, and it’s great to try them all and see what you enjoy the most!

Aerobic Exercises 

Aerobic exercises include walking, running, biking, rowing, dancing and elliptical training. Think of aerobic as heart-pumping exercises that get you breathing more. These are great to improve your blood pressure and cardiovascular health.

Weight Lifting

Even though we think of “lifting weights,” you don’t have to actually use weights! Think of weight lifting exercises like squats, push-ups, sit-ups that don’t require any weight except your own body weight – which counts!

Weight lifting can be helpful for kidney warriors. You don’t need to do it all the time to get benefits from it, either!

While you can absolutely use weights like dumbbells and barbells, don’t forget about other exercise equipment like resistance bands. Even water bottles or cans from your pantry can serve as excellent one- to three-pound weights!

Balance Exercises

As I mentioned in the beginning, the risk of falling increases as we get older. Complications from falls can escalate quickly, and can lead to serious health issues and hospitalizations.

Practicing balancing exercises is a great way to get physical activity in that improves health and safety. Check out this article from Johns Hopkins Medicine (with videos) that show some great balance exercises. 

Stretching

Our muscles want to stretch! That first top to bottom stretch you do in the morning after waking up – isn’t it glorious? A simple way to start increasing your physical activity is to schedule 5-10 minutes in the morning and before bed of simple stretches. Here’s a link to a quick video that walks you through some gentle stretches.

Don’t forget stretch-like exercises like yoga and pilates, which focus on body weight for movement but also to elongate the muscles.

How long should I exercise?

Start small for each of your exercise routines. Even a 5 minute workout is a great place to start! You can always gradually increase your exercise as your body becomes stronger and more capable.

The U.S. Department of Health and Human Services recommends to aim for 30 minutes of moderate exercise for 5 days of the week. That can feel like an ambitious goal when you’re just starting out, so remember that it’s okay to start where you feel comfortable and 

How often should I exercise?

Start small and grow from there. I would not recommend starting with 5 times a week if you don’t exercise at all right now. Maybe one to twice a week is more realistic for you. Remember, this is something to start for a lifetime

Achieving three exercise sessions a week can be beneficial.

How do I know how intense my exercise is?

Try using the “talk test.” The “talk test” is how you can more easily determine the intensity of your exercise. To do the talk test, simply try to talk while exercising.

If you can talk in full sentences, you’re likely doing moderate activity.

Can you sing while exercising? If so, you’re likely doing light activity.

Maybe you can’t string together more than a couple words at a time. That is a sign you’re likely doing some heavy or intense activity.

High intensity (HIIT) exercises generally mean people strive for about 80-90% of your maximum heart rate. To calculate your maximum heart rate, subtract your age from 220. For example, a 50-year-old would have a maximum heart rate of 170. For HIIT exercises, their heart rate goal would be around 136 – 153.

While you should always clear any exercise program with your doctor before starting, it is especially important you discuss any plans to do high-intensity exercise with your doctor first.

When should I exercise?

You should exercise regularly after getting the green light from your doctor. As far as the time of day, do whatever is best for you and your schedule!

Don’t try to plan your routine exercise for a time that will be difficult for you to maintain. If you’re not an early riser, don’t start with 4am exercise times. Sure, moving up the alarm clock gradually to include exercise in the morning is great, but we don’t want to get overwhelmed or frustrated with ourselves.

I worked with a client on becoming a morning exerciser by having her start with setting an alarm for the same time every day. It was a realistic time for her to feel good about getting out of bed, but not angry at the alarm clock. As she got used to it, we started adding in small amounts of exercise for her to fit in.

For example, she started setting her alarm for 8am. She would set 15 minutes in the morning to do some exercises she enjoyed (yoga). A couple weeks later, she pushed her alarm clock up to 7:45am and then bumped up her exercise to 20 minutes. Another few weeks later, 7:30am, and so on.

Now she gets up at 7am and can fit in 30 minutes of exercise and get a healthy breakfast in – all before she starts work! She’s not stressed about her morning routine because she found one that works for her and she enjoys it. (The enjoyment part is a big factor in her success!)

When should I not exercise?

You should not exercise if your doctor has instructed you to refrain from physical activity. It’s also not recommended that you focus on exercising when you feel ill.

Whenever you have any doubts about exercising, talk with your doctor first.

How do I know if I should stop exercising?

Sometimes we can get carried away with exercising. Pay attention to your body while you exercise and stop if you notice symptoms such as;

  • Feeling very tired
  • Short of breath
  • Sick or nauseous
  • Cramping
  • Light-headed or dizzy
  • Chest pain or irregular heart beats

If you have to stop for any reason, you should consult with your doctor and get medically cleared to resume exercising in the future.

Summary

Exercising is so important for our health – for our bodies, our mood, and our kidneys! Pick an activity that you enjoy doing and that feels good to you. Set a time in your day to do your exercise so it becomes a part of your routine.

Find a friend, family member, even your pet to exercise with for more enjoyment of your activity. Get moving so you can feel good about your efforts in keeping your kidneys healthy and happy!

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