How aerobic exercises ease dialysis complications

Kidney disease is among the common non-communicable ailments that are rampant in Kenya. Major risk factors for the disease include diabetes and hypertension, which are also on the rise in the country.

If left untreated, the condition can affect the body’s ability to rid itself of waste products and fluids, which impede the proper functioning of body organs.

This can cause nausea, swelling in the ankles, body weakness, poor sleep and shortness of breath.

Kidney disease can also lead to other health problems such as weak bones, nerve damage and malnutrition.

The most common form of kidney complication is chronic kidney disease. This is a long-term condition that does not improve over time.

It is commonly caused by untreated high blood pressure and diabetes that damage blood cells in the kidneys, contributing to a continuous decline in their ability to function well and keep the body healthy. This eventually leads to kidney failure, which is irreversible.

To avert complications and preserve life, affected individuals usually need to go through dialysis, two to three times a week.

This is a treatment procedure that filters and purifies the blood using a machine.

Patients usually rely on it for survival, until such a time when they can get a kidney transplant.

But some may depend on it eternally if they fail to qualify for kidney transplants due to age or the existence of other infections that make the procedure risky.

Even though the dialysis procedure is beneficial to patients with kidney failure, it also comes with side effects such as anxiety, itchy skin, blood clots, sleeping problems, joint pains and erectile dysfunction that bother patients.

Finding an effective treatment to address these dialysis-related symptoms has been a challenge, forcing patients to keep enduring the suffering. The few available treatments also remain out of reach for vulnerable populations that cannot afford them.

To address this challenge, health experts have discovered that increased physical activity, especially aerobic exercises can come in handy.

These exercises, sometimes known as ‘cardio’, help to condition the heart. They include swimming, cycling, walking, running and jumping rope.

A new study published in the Clinical Journal of the American Society of Nephrology indicates that aerobic exercises may lessen several complications experienced by kidney patients undergoing dialysis.

The researchers note that people with kidney failure often experience multiple and troublesome symptoms such as fatigue, muscle cramping and difficulty sleeping that affect their ability to perform everyday activities and enjoy life.

Yet, undergoing dialysis to treat their kidney failure does not always reduce these symptoms. It can sometimes make some of them worse.

According to the researchers, exercise has recently been identified as a promising potential treatment for these dialysis-related symptoms.

“We found that as little as 20 to 30 minutes of aerobic exercise — two to three times — per week seemed to improve several common symptoms in people undergoing dialysis and make them feel better,” said Dr Clara Bohm, the lead author of the study from the University of Manitoba, based in Canada.

During the study, the researchers retrieved and analysed all relevant studies investigating the effects of aerobic exercises on dialysis-related symptoms.

Their findings revealed that indeed, aerobic exercises could lessen the severity of various complications including restless leg syndrome, depression symptoms, muscle cramping and fatigue that are the common side effects of dialysis.

The restless legs syndrome complication usually causes unpleasant or uncomfortable sensations in the legs, as well as an irresistible urge to move them.

Symptoms commonly occur in the late afternoon or evening hours, and are often most severe at night when a person is resting, such as sitting or lying in bed.

Moving the legs or walking typically relieves the discomfort but the sensations often recur once the movement stops.

This condition can cause exhaustion and daytime sleepiness, which can strongly affect mood, concentration, job performance and personal relationships.

lARGER STUDIES

Based on the researchers’ recommendations, much more studies are still required to unravel additional benefits that physical activities hold for kidney dialysis patients.

“There have been very few rigourous, well-designed published studies that look at the effect of exercise on symptoms in people undergoing dialysis.

“Larger studies that use standardised measurement tools are needed to help us determine the effect of exercise on common symptoms in these patients more clearly,” says Dr Bohm.

Besides, she noted that there are many dialysis-related symptoms for which the effect of exercise has not been studied, and most people included in published trials were men with relatively high levels of physical function.

“Future studies need to include people with diverse characteristics, particularly more women, elderly individuals, and people with low functional status, to see if exercise has similar effects,” she said.

“Also, it is still not clear what exercise intensity and duration are required to see benefits, and if there is a different effect with different types and location of exercise, such as exercise performed during dialysis treatment or outside of dialysis.”

An editorial accompanying the study also noted that it would be crucial to focus on the development of infrastructure for the delivery of effective exercise interventions to tackle the side effects of dialysis.