What is the safety of an exercise program, as an intervention, during hemodialysis for the patient with chronic kidney disease?
PDF (Español (España))
HTML (Español (España))


Exercise therapy – renal dialysis – safety.

How to Cite

Sarmiento Becerra OM, Puentes Salazar AM, Hernández AE. What is the safety of an exercise program, as an intervention, during hemodialysis for the patient with chronic kidney disease?. Rev. Colomb. Nefrol. [Internet]. 2019 Mar. 1 [cited 2023 Jan. 30];6(1):35-47. Available from: https://www.revistanefrologia.org/index.php/rcn/article/view/328


Chronic kidney disease is a high-cost pathology; it has a negative impact on the quality of life, especially in those who underwent hemodialysis. Consequently, it is important to develop strategies to decrease the clinical and economic impact. Intradialytic exercise is a complementary intervention that has shown a decrease in mortality and improvement in the quality of life in these patients. This paper aimed to review the available literature and determine the security of intradialytic exercise, look for population characteristics, training characteristics and the occurrence of adverse effects and their severity. This document is a topic review with a systematic search on Pubmed, OVID, VHL, Clinical Key and LILACS. 8 articles appeared after a keyword search with 15 additional papers discovered by manual research by the authors, the population included adults between 19 and 88 years of age with only 1 paper including a younger population from 9 to 24 years of age. Sex distribution was similar between male and female. Endurance training with a pedal system was the most frequent intervention. The frequency of intervention was 2 to 3 times per week at least for 2 months, and the intensity was low to mild. Some trials mentioned no adverse effect. Those with adverse effects reported cardiovascular alterations (hypotensive/hypertensive episodes), muscular injuries, but none of the adverse effects were considered severe or frequent. With the available information, the authors conclude that intradialytic exercise will be a secure intervention.

PDF (Español (España))
HTML (Español (España))


1. Fondo Colombiano de Enfermedades de Alto Costo. Situación de la enfermedad renal crónica, hipertensión arterial y diabetes mellitus en Colombia. Colombia: Fondo Colombiano de Enfermedades de Alto Costo; 2017. p. 79.

2. Lopera-Medina MM. La enfermedad renal crónica en Colombia: necesidades en salud y respuesta del Sistema General de Seguridad Social en Salud. Rev Gerenc Polít Salud. 2016;15(30):212-33. https://doi.org 10.11144/Javeriana.rgyps15-30.ercc

3. Painter P. Implementing exercise: what do we know? Where do we go? Adv Chronic Kidney Dis. 2009;16(6):536-44. https://doi.org/10.1053/j.ackd.2009.07.010

4. Hernández A, Mongui Y, Rojas Y. Descripción de la composición corporal, fuerza muscular y actividad física en pacientescon insuficiencia renal crónica en hemodiálisis en una unidad renal en Bogotá, Colombia. Rev Andal Med Deporte. 2018;11(2):56-52. https://doi.org/10.1016 j.ramd.2016.09.005

5. Jhamb M, McNulty ML, Ingalsbe G, Childers JW, Schell J, Conroy MB, et al. Knowledge, barriers and facilitators of exercise in dialysis patients: a qualitative study of patients, staff and nephrologists. BMC Nephrol. 2016;17(1):192. https://doi.org/10.1186/s12882-016-0399-z

6. Johansen KL. Exercise in the end-stage renal disease population. J Am Soc Nephrol. 2007;18(6):1845-54. https://doi.org/10.1681/ ASN.2007010009

7. Thompson S, Klarenbach S, Molzahn A, Lloyd A, Gabrys I, Haykowsky M, et al. Randomised factorial mixed method pilot study of aerobic and resistance exercise in haemodialysis patients: DIALY-SIZE!. BMJ Open. 2016;6(9):e012085. https://doi.org/10.1136/ bmjopen-2016-012085

8. Sheng K, Zhang P, Chen L, Cheng J, Wu C, Chen J. Intradialytic exercise in hemodialysis patients: a systematic review and meta- analysis. Am J Nephrol. 2014;40(5):478-90. https://doi.org/10.1159/000368722

9. Paglialonga F, Lopopolo A, Scarfia RV, Consolo S, Galli MA, Salera S, et al. Intradialytic cycling in children and young adults on chronic hemodialysis. Pediatr Nephrol. 2014;29(3):431-8. https://doi.org/10.1007/s00467-013-2675-5

10. Smart N, Steele M. Exercise training in haemodialysis patients: a systematic review and meta-analysis. Nephrology (Carlton). 2011;16(7):626-32. https://doi.org/10.1111/j.1440-1797.2011.01471.x

11. Oh-Park M, Fast A, Gopal S, Lynn R, Frei G, Drenth R, et al. Exercise for the dialyzed: aerobic and strength training during hemodialysis. Am J Phys Med Rehabil. 2002;81(11):814-21. https://doi.org/10.1097/01.PHM.0000030623.81541.DA

12. Spínola Najas C, Mungo Pissulin FD, Lopes Pacagnelli F, Navarro Betônico G, Costa Almeida I, Alberto Neder J. Segurança e Eficácia do Treinamento Físico na Insuficiência Renal Crônica Rev Bras Med Esporte. 2009;15(5). https://doi.org/10.1590/S1517-86922009000600013

13. Böhm J, Monteiro MB, Thomé FS. [Effects of aerobic exercise during haemodialysis in patients with chronic renal disease: a literature review]. J Bras Nefrol. 2012;34(2):189-94. https://doi.org/10.1590/S1517-86922009000600013

14. Segura-Ortí E. Ejercicio en pacientes en hemodiálisis: revisión sistemática de la literatura. Revista Nefrología. 2010;30(2):46. https://doi.org/10.3265/Nefrologia.pre2010.Jan.10229

15. Esteve Simo V, Junqué Jiménez A, Moreno Guzmán F, Carneiro Oliveira J, Fulquet Nicolas M, Pou Potau M, et al. Benefits of a low intensity exercise programme during haemodialysis sessions in elderly patients. Nefrologia. 2015;35(4):385-94. https://doi.org/10.1016/j.nefro.2015.03.006

16. Olvera-Soto MG, Valdez-Ortiz R, López Alvarenga JC, Espinosa-Cuevas MeL. Effect of Resistance Exercises on the Indicators of Muscle Reserves and Handgrip Strength in Adult Patients on Hemodialysis. J Ren Nutr. 2016;26(1):53-60. https://doi.org/10.1053/ j.jrn.2015.06.006

17. Parsons TL, King-Vanvlack CE. Exercise and end-stage kidney disease: functional exercise capacity and cardiovascular outcomes. Adv Chronic Kidney Dis. 2009;16(6):459-81. https://doi.org/10.1053/j.ackd.2009.08.009

18. Mustata S. Groeneveld S. Davidson W. Ford G. Kiland K, et al. Effects of exercise training on physical impairment, arterial stiffness and health-related quality of life in patients with chronic kidney disease: a pilot study. Int Urol Nephrol. (2011) 43:1133-1141.https://doi.org/10.1007/s11255-010-9823-7

19. Konstantinidou E. Koukouvou G. Kouidi E. Deligiannis A. Turkantonis A. Exercise training in patients with end stage renal desease on hemodialysis: comprarison of three rehabilitation programs. J Rehabil Med. 2002;34:(1):40-5.

20. Leaf DA. MacRae HS. Grant E. Kraut J. Isometric Exercise increases the size of forearm veins in patients with chronic renal failure. Am J med Sci 2003; 325(3):115-9.

21. Headley S. Germain M. Wood R. Joubert J. Milch C., et al. Blood pressure response to acute and chronic exercise in chronic kidney disease. Nephrology (Carlton). 2017;22(1):72-78. https://doi.org/10.1111/nep.12730

22. Kouidi E. Grekas D. Deligiannis A. Tourkantonis A. Outcomes of long-term exercise training on muscle atrophy in haemodialysis patients. Nephrol Dial Transplant. 1998;13(3):685-99.

23. Kouidi E. Albani M. Natsis K. Megalopoulos A. Gigis P., et al. The effects of exercise training, in dialysis patients: comparison of two training programs. Clin Nephrol. 2004;61 Suppl1:S31-8.

24. Storer TW. Casaburi R. Sawelson S. Kopple JD. Endurance exercise training during haemodialysis improves strength, power, fatigability and physical performance in maintenance haemodialysis patients. Nephrol Dial Transplant. 2005;20(7):1429-37. https://doi.org/10.1093/ndt/gfh784

25. Chiew H, James T, Roger N, Ken F. The effect of exercise during a haemodialysis on solute removal. Nephrol Dial Transplant. 1999;14:2927-2931. https://doi.org/10.1093/ndt/14.12.2927

26. Painter PL, Hector L, Ray K, Lynes L, Dibble S., et al. A randomized trial of exercise training after renal transplantation. Transplantation. 2002,15;74(1):42-8.

27. Macdonald JH, Marcora SM, Jibani M, Phanish MK, Holly J, et al. Intradialytic exercise as anabolic therapy in haemodialysis patients — a pilot study. Clin Physiol Funct Imaging. 2005;25(2):113-8. https://doi.org/10.1111/j.1475-097X.2004.00600.x

28. Cheema B, Abas H, Smith B, O’Sullivan A, Chan M., et al. Progressive exercise for anabolism in kidney disease (PEAK): a randomized, controlled trial of resistance training during hemodialysis. J Am Soc Nephrol. 2007;18(5):1594-601. https://doi.org/10.1681/ ASN.2006121329

29. DePaul V, Moreland J, Eager T, Clase CM. The effectiveness of aerobic and muscle strength training in patients receiving hemodialysis and EPO: a randomized controlled trial. Am J Kidney Dis. 2002;40(6):1219-29. https://doi.org/10.1053/ajkd.2002.36887

30. Koufaki P, Mercer TH, Naish PF. Effects of exercise training on aerobic and functional capacity of end-stage renal disease patients. Clin Physiol Funct Imaging. 2002;22(2):115-24.
No national or foreign publication may partially or totally reproduce or translate Revista Colombiana de Nefrología articles or abstracts without prior written permission from the journal’s Editorial Board.




Download data is not yet available.