Staying Fit With Kidney Disease

Transcription

1 Staying Fit With Kidney Disease

2 Many people with chronic kidney disease (CKD) are enjoying the improved health and increased physical strength that come from a regular exercise routine. You may want to begin exercising on a regular basis, but have questions about what your limits are and what activities you can or can't engage in. This brochure is designed to answer some of your questions. Can I take part in vigorous physical activity? Yes. In the past, it was thought that people with kidney disease would not be able to participate in vigorous activity. We know now that patients who decide to follow an exercise program are stronger and have more energy. There was a time when anemia left CKD patients feeling too tired and weak to exercise. The drug erythropoietin (EPO) has changed all that. People who treat their anemia with EPO are better able to engage in physical activity and will, therefore, get more out of an exercise regimen. 2 NATIONAL KIDNEY FOUNDATION

3 How does exercise benefit me? When you begin to exercise regularly, one of the first things you will notice is an increase in the amount of energy that you have. Not only will that make it easier for you to continue with your new workout regimen, it will make it easier for you to go to work, accomplish the goals you set for yourself, and engage in any hobbies or pastimes that you enjoy. In addition, you may find yourself enjoying some of the other benefits of regular exercise: Better blood pressure control Lower levels of blood fats (cholesterol and triglycerides) Better, deeper sleep Better weight control. Just as high blood pressure, high blood fats, kidney disease and being overweight increase your risk of developing heart disease, exercise may lessen your risk of heart disease. Exercise may also help to prevent a weakening of bones a problem that dialysis and transplant patients often have. People who exercise are usually less depressed, worry less, are better able to do things for themselves and feel better about themselves. Do I need to see my doctor before starting to exercise? Yes. Before beginning any exercise program, be sure to check with your doctor. If you have had heart problems, or your doctor is concerned about your cardiac health, you may NATIONAL KIDNEY FOUNDATION 3

4 need to have a stress test. This will provide information about what physical activity you can do. It is important to establish a pattern of regular physical activitiy as early in your treatment as possible. It is important that you follow your treatment plan. You should take your medicines and follow your diet and any other instructions your health care team gives you. If you don t, you may develop problems that could be made worse by exercise. For example, if you have not followed your diet and your heart and lungs are strained by fluid overload, exercise could increase the stress on these organs. How can I begin an exercise program? When it comes to exercise, there are no general instructions that apply to all CKD patients. Some patients begin exercise programs with the use of stationary equipment exercise bikes or treadmills during hemodialysis treatment. Other patients may want to start a walking program. Each person's health, fitness level and available time will differ. The following guidelines about exercise may be helpful. 4 NATIONAL KIDNEY FOUNDATION

5 When planning an exercise program, you need to look at four things: Type of exercise Length of time you spend exercising How often you exercise How hard you work while exercising. Type of exercise Continuous activities such as walking, swimming, bicycling (indoors or out), skiing, or aerobics are good for cardiovascular health. They require you to continuously move large groups of muscles and do not place a great strain on any one muscle. If you suffer from joint pain, swimming may be the best choice for you since it places the least stress on your joints. Another popular way for people to stay in shape is by doing yoga. Yoga is a low-impact form of exercise in which you tone your muscles with slow movements and by holding various postures. Many people find it to be a very relaxing way to exercise. It may be a good idea to include some lowlevel strength training in your exercise program. Using lighter weights and doing more repetitions will help you to avoid joint problems. Heavy lifting should be avoided, as a rule of thumb. How long to exercise Work toward 30-minute sessions. You should build up to this level gradually. Begin with whatever is comfortable. For example, NATIONAL KIDNEY FOUNDATION 5

6 during the first week try starting with five minutes of continuous activity. Then, the next time you exercise, add one minute to your routine and go from there, adding one or two minutes whenever you feel ready to do so. There is nothing magical about 30 minutes. If you feel like exercising for 45 to 60 minutes, go ahead. Just be sure to follow the advice listed in this brochure under "When should I stop exercising?". When you begin to exercise, a short walk two times a day might be very effective. Longer walks (60 minutes) may be more effective when it comes to controlling your weight, but these should not be attempted until you become comfortable with your exercise routine. How often to exercise Exercise at least three days a week. These should be non-consecutive days, for example Monday, Wednesday and Friday. Three days a week is the minimum requirement to achieve the benefits of regular exercise. 6 NATIONAL KIDNEY FOUNDATION

7 How hard to work while exercising This is the area that is the most difficult to discuss without knowing an individual s specific physical condition and his or her capacity for exercise. The following guidelines are usually helpful: You should not be breathing so hard that you cannot talk to someone exercising with you. (Try to exercise with a partner such as a family member or a friend.) You should feel completely normal within one hour after exercising. If not, slow down next time. You should not feel so much muscle soreness that it keeps you from exercising the next time. Start each session slowly: warm up, then pick up your pace, then cool down again when you are about to finish. The most important thing is to start slowly and progress gradually, allowing your body to adapt to the increased levels of activity. When should I exercise? Try to schedule your exercise into your normal day. Here are some ideas about when to exercise: Wait one hour after a large meal. Avoid very hot times of the day. Morning or evening tend to be the best times for exercising. Do not exercise less than an hour before you go to sleep. NATIONAL KIDNEY FOUNDATION 7

8 When should I stop exercising? If you feel very tired If you are short of breath If you feel chest pain I f you feel irregular or extremely rapid heart beats If you feel sick to your stomach If you get leg cramps If you feel dizzy or light-headed. Are there any times when I should not exercise? Yes. You should not exercise without talking with your doctor, or if any of the following occurs: You have a fever. You have changed your dialysis schedule. You have changed your medication schedule. Your physical condition has changed. You have eaten too much. 8 NATIONAL KIDNEY FOUNDATION

9 The weather is very hot and humid (unless you exercise in an air-conditioned facility). You have joint or bone problems that become worse with exercise. If you stop exercising for any of these reasons, speak to your doctor before beginning again. What if I have more questions? If you have more questions, you should speak to your doctor. You should always check with your doctor before beginning any exercise program. Exercise has given new energy and enthusiasm to many people with kidney disease. Working toward better physical fitness is a way of gaining control over some of the many changes in your life. It is possible to be physically fit after kidney failure. It takes hard work and the ability to "stick to it," but as many patients can tell you, the results are worth the effort. Other resources You may obtain copies of these other brochures from your local National Kidney Foundation affiliate: Working With Kidney Disease: Rehabilitation and Employment Coping Effectively: A Guide for Patients and Their Families Sexuality and Chronic Kidney Disease. Another resource you may find helpful is a video program called Exercise for the Dialysis Patient: A Comprehensive Program. Ask the health care team at your dialysis center about this program. NATIONAL KIDNEY FOUNDATION 9

10 More than 20 million Americans one in nine adults have chronic kidney disease, and most donʼt even know it. More than 20 million others are at increased risk. The National Kidney Foundation, a major voluntary health organization, seeks to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases, and increase the availability of all organs for transplantation. Through its 47 affiliates nationwide, the foundation conducts programs in research, professional education, patient and community services, public education and organ donation. The work of the National Kidney Foundation is funded by public donations. Education Along the Continuum of Care This arrow illustrate the potential scope of content for KLS resources. Lightshaded boxes indicate the scope of content targeted in this resource. GFR = Glomerular Filtration Rate; T = Kidney Transplant; D = Dialysis National Kidney Foundation 30 East 33rd Street New York, NY , 1996, 2003 National Kidney Foundation, Inc Edition. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the National Kidney Foundation