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Exercise programmes have been called for in routine care plans for patients with chronic kidney disease,1 ,2 but nephrologists still hesitate to prescribe exercise during haemodialysis,3 especially for patients with end-stage renal disease (ESRD). One reason may be the age of patients with ESRD, a vulnerable population at high risk of mortality. Now more than ever, whether for paediatric patients4 or older patients (>65 years of age),5 let's challenge this intrinsic reluctance by advocating intradialytic exercise programmes as part of the standard care for patients receiving dialysis.
Exercise is effective for patients with ESRD6—it increases maximal oxygen uptake capacity, improves blood-pressure control, decreases arterial stiffness, decreases systemic inflammation, improves solute removal by dialysis, increases muscle force, and augments perceived quality of life (QoL). Beyond outstanding issues regarding the precise exercise prescription (endurance vs resistance training), the critical question is not whether to include …
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.