I read an article about muscle wasting in hemodialysis patients and was wondering what can be done to prevent it from happening. The article states, “Endurance (aerobic) and resistance (anaerobic or strength training) exercise have been reported to reduce muscle wasting in HD patients.” It also states, “In a typical endurance exercise program, at least 30 minutes per day of moderate intensity exercise must be performed 5 days per week…[and a] resistance exercise program should be performed gradually and at least twice a week and should include training for all the major muscle groups.” I would like to know what type of exercises are they talking about, pushups, body weight squats, etc.? I was told by my nephrologist that patients on hemodialysis can’t do these types of exercises due to the fistula in their arms? I would also like to know if the type of muscle stimulators that are used by Bruce Lee on his muscles can be used by a patient on hemodialysis. What is the correct answer?

Exercises recommended for dialysis patients include walking, bicycling, swimming and jogging.  Dialysis patients may also use light weight lifting as a repetitive exercise.  It is true that these exercises are recommended to be done for approximately 150 minutes per week.  Dialysis patients with a fistula should not lift heavy weights that require the individual to strain and tighten their abdominal muscles while holding their breath.  This is known as a Valsalva maneuver and this causes an abrupt increase in your blood pressure and is not good for your heart, your blood pressure or your fistula.

Hence, I would recommend daily walking, jogging, swimming or bicycling coupled with lifting light weights for your upper body, arms and chest.  I do not recommend weight lifting, pushups, or body weight squats.  I would also not recommend using any device to stimulate your muscles.  Natural movements are the best exercise for your heart and your muscles.


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