Living with Stage 4 Chronic Kidney Disease

Exercise and physical activity

Exercise is an important way to improve your health, whether or not you have kidney disease. Regular exercise can provide a number of benefits, including the following:

• Helps keep many parts of your body healthy, including bones, muscles, blood vessels, heart and kidneys

• Helps you lose excess weight, control blood pressure and lower blood sugar

• Makes you more flexible and stronger

• Helps you handle stress

• Can improve your mood

Regardless of your age, getting regular exercise can help you feel better and improve your health.

Types of exercise and physical activity

There are many kinds of exercise you can do, such as light weights, light jogging/treadmill, or bicycling (indoors or out).

Along with what we usually call “exercise,” there are a number of things you can do to get more physical activity, including walking, gardening, household chores, or dancing.

It is important to realize there are many ways to get more exercise and physical activity. You can try different activities and decide which ones you enjoy the most and those that fit best in your daily life.

You may need to start off with lower intensity (how hard you exercise), duration (how long you exercise at any given time) and frequency (how often you exercise). You may need to start slowly and progress gradually, allowing your body to adapt to the increased levels of activity. Once you are comfortable with a routine, you can eventually increase your intensity, duration and frequency as much as you can without exerting yourself.

An exercise program approved by your healthcare team can increase strength and endurance, prevent fatigue, reduce stress and depression and increase the overall quality of day-to-day living. Before beginning an exercise program, it is important to consult a clinician and remember the difference between "doing" and "overdoing." An exercise program should be planned to meet your special needs.

Incorporating more physical activity in your daily routine

Whether you are getting started, or maintaining an exercise routine, staying motivated and including more physical activity as part of regular routine is very important, but it can be a challenge. There are a number of ways to help you stay with your exercise routine, including the following:

• Avoid injuries by easing into a new routine, and stretching before and after exercising

• Exercise while watching TV (stretching, light treadmill, exercise bike, etc.)

• Fit exercise and physical activity into your home routine (walk or bike to the store, park your car at a distance from the store entrance, walk your dog more often, schedule enough time for chores around your home)

• Try to fit more physical activity into your work and commute (incorporate more walking and bike riding into your commute, take the stairs instead of the elevator, walk during your lunch hour)

• Choose exercises and physical activities that you like

• Exercise with a partner or group

• Sign up for a class (yoga, aerobics, etc.)

• Have more variety in your exercise routine

• Exercise with music

• Remain positive, even on difficult days or if you do not notice progress right away

• Set goals for yourself and monitor your progress. Adjust them according to how well you do

• Reward yourself if you reach a certain goal

You may need to try different methods to see which ones work best in helping you keep up with your routine. Deciding that you need more exercise and starting a routine is an important first step for a healthier life. However, you will only realize any health benefits if you get regular exercise and physical activity, and stay with your routine.

Avoiding Smoking

In addition to causing lung cancer and lung disease, smoking is also associated with kidney disease, kidney cancer and bladder cancer. Smoking slows the blood flow to vital organs like the kidneys, causing damage. Smoking can affect medicines used to treat high blood pressure. Uncontrolled or poorly controlled high blood pressure is a leading cause of kidney disease. Smoking slows the blood flow to important organs like the kidneys and can make kidney disease worse. If you have kidney disease, smoking can make it even worse. Smoking also raises the chance of a heart attack or stroke.

Quitting smoking can be difficult. Many programs are available to help smokers quit. Your clinician can also offer suggestions to help you quit. Tips include the following:

• Choose a date to stop

• Change your environment

• Let others know you're quitting

• Talk to a clinician about quitting and about medications that can help

• Be prepared to fight urges

• Stay away from places where you smoked or people you smoked with

• Remind yourself about why you want to quit

• Find something else to put in your hands or your mouth

• Practice relaxation strategies and deep breathing

Limiting or avoiding alcohol

Drinking alcohol can affect many parts of your body, including your kidneys. A little alcohol—one or two drinks now and then—usually has no serious effects. Some people should not drink at all, especially if they have certain condition such as liver disease. Regardless of your drinking, too alcohol much can harm your health. It can also worsen kidney disease.

Your kidneys filter harmful substances from your blood. One of these substances is alcohol. Alcohol can cause changes in the function of the kidneys and make them less able to filter your blood. In addition to filtering blood, your kidneys do many other important jobs. One of these jobs is keeping the right amount of water in your body. Alcohol affects the ability of your kidneys to do this.

Too much alcohol can also affect your blood pressure. People who drink too much are more likely to have high blood pressure. And medications for high blood pressure can be affected by alcohol. Chronic drinking can also cause liver disease. This adds to the kidney's job. The rate of blood flow to your kidneys is usually kept at a certain level, so that your kidneys can filter your blood well. Liver disease impairs this important balancing act.

Always check with your clinician to make sure it is safe for you to drink alcohol, and if so what is a safe amount. Even if it is safe, it is important to drink in moderation.

What can I do to maintain a better lifestyle?

• Try to incorporate more physical activity into your routine
• Before beginning any exercise program, be sure to check with your clinician
• When planning a directed exercise program, ask a clinician about the following:
• Type of exercise
• Length of time you spend exercising
• How often you exercise
• How hard you work while exercising
• Remain positive, even on difficult days or if you do not notice progress right away
• Avoid smoking. Ask for help if you have trouble quitting

• Ask your clinician about limiting or avoiding alcohol

Finally, ask others for help. Exercising with a partner or group can help with motivation and maintaining regular exercise routine, and thus a healthy lifestyle. This flyer contains additional tips on how to maintain an activity schedule.