What is Kidney Failure?
The kidneys are two bean-shaped organs about the size of a fist that filter extra water and wastes out of your blood and make urine. In the presence of kidney damage, they can’t filter blood the way they should, therefore leading to the accumulation of waste products and fluid. Kidney failure occurs when the stimulus that is causing the damage, is prolonged and sustained, which leads to the constant injury and destruction of cells overtime. You are at greater risk for kidney disease if you have diabetes or high blood pressure. The disease is called “chronic” because the damage to your kidneys happens slowly over a long period of time. If you experience kidney failure, treatments include a kidney transplant or dialysis.
Dialysis is a treatment that mimics the mechanisms of healthy kidneys and is needed when you kidneys can no longer keep up with your body’s demands due to the repeated and sustained damage. Dialysis is usually administered when you develop end stage kidney failure which is clinically classified by a glomerular filtration rate of <15 or loss of 80-90% of your kidney function. When your kidneys fail, dialysis keeps your body in balance by removing waste, salt and extra water to prevent them from building up in the body, as well as keeping a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate and also helping to control blood pressure. In chronic or end stage kidney failure, your kidneys will very rarely increase in function and therefore you will need lifelong dialysis. There are two type of dialysis – haemodialysis or peritoneal. Haemodialysis utilises an external artificial kidney to remove waste, extra chemical and fluid from your blood. Usually haemodialysis is completed three times a week for about 4 hours, however, is very individualised. While peritoneal dialysis involves cleaning your blood inside your body through the injection of dialysate via a catheter
Benefits of Exercise with End Stage Kidney Failure
Individuals who complete regular supervised session (as opposed to unsupervised sessions and sedentary individuals) have better quality of life, mental health, physical functioning, sleep quality scores, report fewer physical activity limitations and are less affected by pain or poor appetite. Along with this both low and high intensity exercise increases aerobic capacity. While resistance training increases muscular strength and endurance depending on the stimulus. Along with this, exercise training improves central haemodynamics (reduced blood pressure and resting heart rate), with the majority of benefits observed in those who performed high intensity exercise. Exercise has also shown to improve blood glucose levels in those with kidney failure. There is also evidence that suggest that exercise also aids in decreasing inflammation and oxidative stress and improving solute removal during dialysis, however, this is subjective to the individual.
It is important to note that all exercise for those with kidney failure, and/or on dialysis to be prescribed and supervised by an Accredited Exercise Physiologist, due to the complexity of the disease and the complications that can arise. As Exercise Physiologists, we are educated with regards to the pathophysiology of the disease and the effects exercise can have on certain physical and physiological mechanisms, that can potentially cause harm if administered incorrectly.