Clinical Question

What are the benefits of regular exercise for adults undergoing maintenance dialysis?

Evidence-Based Answer

Regular exercise probably improves functional capacity for adults undergoing maintenance dialysis and might be associated with small improvements in pain, depression, and quality of life; it is uncertain whether any effect on risk of death or cardiovascular outcomes occurs.¹ (Strength of Recommendation: B, systematic review and meta-analysis of lower-quality clinical trials.)

Practice Pointers

For patients with end-stage renal disease, peritoneal dialysis and hemodialysis can prolong life compared with conservative management. However, dialysis is also associated with a considerable commitment of time, and patients are at risk of discomfort and complications. Up to 60% of patients who initiate dialysis later regret the decision.² A previous Cochrane review found that regular exercise could improve fitness, walking capacity, and health-related quality of life among patients with all stages of chronic kidney disease.³ The authors of this review sought to evaluate the effects of regular structured exercise training on death, cardiovascular events, fatigue, depression, functional capacity, and pain for adults with end-stage renal disease who were undergoing dialysis.