Physical activity amongst hemodialysed patients – why lack of motivation to exercise is present?

Agnieszka Turoń-Skrzypińska, Natalia Tomska, Artur Uzdzicki, Tomasz Przybylski, Grażyna Dutkiewicz, Iwona Rotter



In recent years a great interest in rehabilitation and physical activity amongst hemodialysed patients have developed. Despite having numerous exercise options, adverse effects of a lack of movement still are seen in this group of patients. The reasons of insufficient physical activity amongst hemodialysed patients are complications related to chronic diseases and renal replacement therapy. For patients suffering from kidney failure it is crucial to adhere to recommendations relating to regular physical activity in order to maintain health and good quality of life.


Physical activity; hemodialysis; chronic kidney disease

Full Text:



Nelson RG., Tuttle KR., Bilous RW., Gonzalez-Campoy JM., Mauer M., Molitch ME et al. (2012). KDOQI Clinical Practice Guideline for Diabetes and CKD: 2012 Update. Am J Kidney Dis, 60 (5): 850–886.

Baggetta R., D’Arrigo G., Torino C., ElHafeez SA., Manfredini F., Mallamaci F., et al. (2018). Effect of a home based, low intensity, physical exercise program in older adults dialysis patients: a secondary analysis of the EXCITE trial. BMC Geriatr. 18 (1): 248. Doi: 10.1186/s12877-018-0938-5.

Bowlby W., Zelnick LR., Henry C., Himmelfarb J., Kahn SE., Kestenbaum B., et al. (2016). Physical activity and metabolic health in chronic kidney disease: a cross-sectional study. BMC Nephrol. 17 (1): 187. Doi: 10.1186/s12882-016-0400-x.

Kopple JD., Storer T., Casburi R. (2005). Impaired exercise capacity and exercise training in maintenance hemodialysis patients. J Ren Nutr. 15 (1): 44–48.

Szymańska A., Filaszkiewicz M., Niemczyk M. (2017). Aktywność fizyczna u pacjentów leczonych hemodializami. Nefrol. Dial. Pol. 21, 173–175.

Arem H., Moore SC., Patel A., Hartge P., Berrington de Gonzalez A., Visvanathan K., et al. (2015). Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Intern Med. 175 (6): 959-967. Doi: 10.1001/jamainternmed.2015.0533.

Block GA., Klassen PS., Lazarus JM., Ofsthun N., Lowrie EG., Chertow GM. (2004). Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 15 (8): 2208-2218. Doi: 10.1097/01.ASN.0000133041.27682.A2.

Kalantar-Zadeh K., Kuwae N., Regidor DL., Kovesdy CP., Kilpatrick RD., Shinaberger C. S., et al. (2006). Survival predictability of time-varying indicators of bone disease in maintenance hemodialysis patients. Kidney Int. 70 (4): 771–780. Doi: 10.1038/

Storer TW. (2013). Exercise Training for Individuals with Advanced Chronic Kidney Disease. W: Joel D., i in., red: Nutritional management of renal disease. 3rd ed. Amsterdam: Academic Press. 739–773. ISBN: 978-0-12-391934-2.

Castaneda C., Gordon PL., Parker RC., Uhlin KL., Roubenoff R., Levey AS. (2004). Resistance training to reduce the malnutrition-inflammation complex syndrome of chronic kidney disease. Am J Kidney Dis. 43 (4): 607-616.

Hsieh RL., Lee WC., Huang HY., Chang CH. (2007). Quality of life and its correlates in ambulatory hemodialysis patients. J Nephrol. 20 (6): 731–738.

Tudor-Locke C. (2001). A preliminary study to determine instrument responsiveness to change with a walking program: physical activity logs versus pedometers. Res Q Exerc Sport. 72 (3): 288–292. Doi: 10.1080/02701367.2001.10608962.

Cook WL., Jassal SV. (2008). Functional dependencies among the elderly on hemodialysis. Kidney Int. 73 (11): 1289-1295. Doi: 10.1038/ki.2008.62.

Kurella TM., Covinsky KE., Chertow GM., Yaffe K., Landefeld CS., McCulloch CE. (2009). Functional status of elderly adults before and after initiation of dialysis. N Engl J Med. 361 (16): 1539–1547. Doi: 10.1056/NEJMoa0904655.

Fried LP., Tangen CM., Walston J., Newman AB., Hirsch C., Gottdiener J., et al. (2001). Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 56 (3): M146-56.

Wuerth D., Finkelstein SH., Finkelstein FO. (2005). The identification and treatment of depression in patients maintained on dialysis. Semin Dial. 18 (2): 142–146. Doi: 10.1111/j.1525-139X.2005.18213.x.

Delgado C., Johansen K.L. (2012). Barriers to exercise participation among dialysis patients. Nephrol Dial Transplant. 27 (3): 1152-1157. Doi: 10.1093/ndt/gfr404.

Goodman ED., Ballou MB. (2004). Perceived barriers and motivators to exercise in hemodialysis patients. Nephrol Nurs J. 31 (1): 23–29.

Jayaseelan G., Bennett PN., Bradshaw W., Wang W., Rawson H. (2018). Exercise Benefits and Barriers: The Perceptions of People Receiving Hemodialysis. Nephrol Nurs J. 45 (2): 185–219.

Wojczyk A. (2014). Problemy codziennego życia hemodializowanych pacjentów. Piel Zdr Publ. (4): 143–148.

Birmelé B., Le Gall A., Sautenet B., Aguerre C., Camus V. (2012). Clinical, sociodemographic, and psychological correlates of health-related quality of life in chronic hemodialysis patients. Psychosomatics. 53 (1): 30-37. Doi: 10.1016/j.psym.2011.07.002.

Nowicki M., Murlikiewicz K., Jagodzińska M. (2010). Pedometers as a means to increase spontaneous physical activity in chronic hemodialysis patients. J Nephrol. 23 (3): 297–305.

Stewart AL., Hays RD., Wells KB., Rogers WH., Spritzer KL. Greenfield S. (1994). Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the Medical Outcomes Study. J Clin Epidemiol. 47 (7): 719–730.

Barinow-Wojewódzki A. (2013). Fizjoterapia w chorobach wewnętrznych. PZWL, Warszawa. ISBN: 978-83-200-4387-7.

Rutkowski B. (2007). Leczenie nerkozastępcze. Wyd. Czelej, Lublin. ISBN:978-83-60608-11-1.

Qiu Z., Zheng K., Zhang H., Feng J., Wang L., Zhou H. (2017). Physical Exercise and Patients with Chronic Renal Failure: A Meta-Analysis. Biomed Res Int. Doi: 10.1155/2017/7191826.

Cobo G., Gallar P., Gama-Axelsson T., Di Gioia C., Qureshi AR., Camacho R., et al. (2015). Clinical determinants of reduced physical activity in hemodialysis and peritoneal dialysis patients. J Nephrol. 28 (4): 503-510. Doi: 10.1007/s40620-014-0164-y.

Hiraki K., Shibagaki Y., Izawa KP., Hotta C., Wakamiya A., Sakurada T., et al. (2017). Effects of home-based exercise on pre-dialysis chronic kidney disease patients: a randomized pilot and feasibility trial. BMC Nephrol. 18 (1): 198. Doi:10.1186/s12882-017-0613-7.

Akber A., Portale AA., Johansen KL. (2014). Use of pedometers to increase physical activity among children and adolescents with chronic kidney disease. Pediatr nephrol. 29 (8): 1395-1402. Doi: 10.1007/s00467-014-2787-6.

Hino K., Asami Y., Lee JS. (2019). Step Counts of Middle-Aged and Elderly Adults for 10 Months Before and After the Release of Pokémon GO in Yokohama, Japan. J Med Internet Res. 21 (2): e10724. Doi: 10.2196/10724.

Graells-Garrido E., Ferres L., Caro D., Bravo L. (2017). The effect of Pokémon Go on the pulse of the city: a natural experiment. EPJ Data Sci. 6 (1): 667. Doi: 10.1140/epjds/s13688-017-0119-3.

Kogan L., Hellyer P., Duncan C., Schoenfeld-Tacher R. (2017). A pilot investigation of the physical and psychological benefits of playing Pokémon GO for dog owners. Comput Human Behav. 76: 431–437. Doi: 10.1016/j.chb.2017.07.043.

Liu W., Ligmann-Zielinska A. (2017). A Pilot Study of Pokémon Go and Players' Physical Activity. Games Health J. 6 (6): 343–350. Doi: 10.1089/g4h.2017.0036.

Nigg CR., Mateo DJ., An J. (2017). Pokémon GO May Increase Physical Activity and Decrease Sedentary Behaviors. Am J Public Health. 107 (1): 37–38. Doi: 10.2105/AJPH.2016.303532.

Wong FY. (2017). Influence of Pokémon Go on physical activity levels of university players: a cross-sectional study. Int J Health Geogr. 16 (1): 8. Doi: 10.1186/s12942-017-0080-1.

Jankowska M., Haarhaus M., Qureshi A.R., Lindholm B., Evenepoel P., Stenvinkel P. (2017). Sclerostin─A Debutant on the Autosomal Dominant Polycystic Kidney Disease Scene? Kidney Int Rep. 2 (3): 81–485. Doi: 10.1016/j.ekir.2017.01.001.

Piotrowicz E., Piotrowicz R. (2013). Cardiac telerehabilitation: current situation and future challenges. Eur J Prev Cardiol. 20 (2): 12–16. Doi: 10.1177/2047487313487483c.

Weber-Nowakowska K., Gębska M., Myślak M., Żyżniewska-Banaszak E., Stecko M. (2017). Rola aktywności fizycznej w leczeniu pacjentów z przewlekłą chorobą nerek. Pomeranian J Life Sci. (63): 27–30.

Kong CH., Tattersall JE., Greenwood RN., Farrington K. (1999). The effect of exercise during haemodialysis on solute removal. Nephrol Dial Transplant. 14 (12): 2927–2931.

Chung YC., Yeh ML., Liu YM. (2017). Effects of intradialytic exercise on the physical function, depression and quality of life for haemodialysis patients: a systematic review and meta-analysis of randomised controlled trials. J Clin Nurs. 26 (13-14): 1801-1813. Doi: 10.1111/jocn.13514.

Mohseni R., Emami Zeydi A., Ilali E., Adib-Hajbaghery M., Makhlough A. (2013). The Effect of Intradialytic Aerobic Exercise on Dialysis Efficacy in Hemodialysis Patients: A Randomized Controlled Trial. Oman Med J. 28 (5): 345–349. Doi: 10.5001/omj.2013.99.

Anding K., Bär T., Trojniak-Hennig J., Kuchinke S., Krause R., Rost JM., et al. (2015). A structured exercise programme during haemodialysis for patients with chronic kidney disease: clinical benefit and long-term adherence. BMJ open. 5 (8): e008709. Doi: 10.1136/bmjopen-2015-008709.

Manfredini F., Mallamaci F., D'Arrigo G., Baggetta R., Bolignano D., Torino C., et al. (2017). Exercise in Patients on Dialysis: A Multicenter, Randomized Clinical Trial. J Am Soc Nephrol. 28 (4): 1259–1268. Doi: 10.1681/ASN.2016030378.

Koh. KP., Fassett RG., Sharman JE., Coombes JS., Williams AD. (2010). Effect of intradialytic versus home-based aerobic exercise training on physical function and vascular parameters in hemodialysis patients: a randomized pilot study. Am J Kidney Dis. 55 (1): 88–99. Doi: 10.1053/j.ajkd.2009.09.025.

Krause R. (2004). WGRR-European Working Group on Renal Rehabilitation and Exercise Physiology (affi liated to the ERA-EDTA), KfH-Kuratorium für Dialyse und Nierentransplantation e.V., Nephrological Centre BerlinMoabit: Nephrologists’ view on exercise training in chronic kidney disease (results of the questionnaire at the WCN 2003. Clin Nephrol. (61): 2–4.

Hornik B. Janusz-Jenczeń M., Włodarczyk I. (2017). Przestrzeganie zaleceń aktywności fizycznej przez chorych hemodializowanych. W: Dybińska E., Szpringer M., Asienkiewicz R.: Profilaktyka i edukacja zdrowotna. Wydawnictwo Naukowe Neurocentrum, Lublin. 109-122. ISBN: 978-83-61495-79-6.

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


  • There are currently no refbacks.

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. Zgodnie z Rozporządzeniem ministra nauki i szkolnictwa wyższego z dnia 22 lutego 2019 r. w sprawie ewaluacji jakości działalności naukowej (w szczególności art. 12 ust. 1 pkt 1 w zw. z art. 8 pkt 2), czasopismo Pedagogy and Psychology of Sport ewaluowane jest punktacją w wysokości 5 punktów. e-ISSN: 2450-6605 Numer DOI: 10.12775/PPS Indexing: Index Copernicus Master List DOAJ ERIH Plus Polska Bibliografia Naukowa PBN Akademicka Platforma Czasopism Naukowych Google Scholar BASE CrossRef WorldCat Arianta Baidu Scholar J-Gate JournalTOCs Microsoft Academic POL-index

Partnerzy platformy czasopism