Benefits of Physical Exercise in Patients with Chronic Kidney Disease and Hemodialysis: A Mini Review

Abstract

Protein Energy Wasting (PEW) is characterized by abnormalities in skeletal muscle with a significant decrease in physical function and increased morbidity and mortality. Among all the factors associated with mortality of hemodialysis patients, impaired physical function is a factor that can be easily and directly modified by exercise. Different studies have shown that physical exercise significantly improves muscle strength and physical function. The implementation of a structured resistance exercise (RE) program during the hemodialysis sessions is a safe and effective intervention that helps to improve physical performance, nutritional status, quality of life, anabolic response, and muscle strength, being also effective to reduce inflammation and PEW. Chronic kidney disease is a catabolic state that activates different intracellular signaling pathways that decrease protein synthesis and increase protein degradation. There is enough evidence to establish the safety and benefits of performing exercise in patients on hemodialysis, however, there are other lines of research that are being developed to support this. It is necessary to continue evaluating exercise in prospective and long term studies. In conclusion, we must consider that patients on hemodialysis who perform physical activity are under a safe and non-pharmacological intervention that does not require an extra cost with promising results to prevent deleterious outcomes such as PEW, frailty and impaired physical function.