Physical Activity in Kidney Disease: Exercise & Protein in CKD
- Brandy Winfree Root, RDN, CSR, LDN
- 3 days ago
- 4 min read
Chronic Kidney Disease (CKD) affects more than 10% of the population globally and brings numerous challenges to daily life. Managing CKD often involves balancing medications and dietary restrictions, but many overlook the significant role physical activity and protein intake can play in enhancing kidney health and maintaining muscle mass. So today, we're going to explore how exercise and protein intake work together to improve overall well-being for those living with CKD.
Chronic Kidney Disease and Muscle Breakdown
Before we discuss exercise and protein, it's essential to understand that simply having CKD can cause muscle to breakdown. As the kidneys gradually lose their ability to filter waste and fluid and to produce needed hormones to keep the body healthy, waste products build up and hormones aren't created quickly enough, the body can break down it's own muscle.
We, the healthcare team, tend to focus on getting enough protein to prevent muscle breakdown. But, we may be missing a big piece of the puzzle.
A recent analysis in the Journal of Renal Nutrition suggests that simply eating (or drinking) protein isn't enough to fight off muscle breakdown. The analysis found that people living with kidney disease who combined exercise with adequate protein intake saw more health benefits than those who only had a protein supplement, including:
Improved Strength
Increased Muscle Mass
Improved Mobility
Improved Cardiopulmonary Fitness
The Importance of Physical Activity In Kidney Disease
Physical activity offers numerous health benefits, especially for individuals managing CKD. Regular exercise can lead to:
Lower blood pressure: Even moderate physical activity can help reduce blood pressure by about 5–10 mmHg in many individuals.
Weight management: Physical activity can help to promote a healthy weight, reducing stress on the kidneys.
Improved mood: Exercise can combat feelings of anxiety and depression, which often accompany CKD.
KDIGO, the international, non-profit organization made up of healthcare professionals and researchers that develop guidelines for kidney care, recommends 150 minutes of moderate exercise every week for people living with CKD. That may seem like a lot, but moderate exercise can be as simple as a brisk walk, a bike ride, or gardening and 150 minutes comes out to 50 minutes of exercise about 5 times a week.

Incorporating a mix of aerobic and resistance training can be beneficial. Aerobic exercises like walking, cycling, and swimming improve cardiovascular health. While strength training, like lifting weights, doing planks or push-ups, and using resistance bands, builds and maintains muscle mass, crucial for overall health.
Protein: The Essential Nutrient
Proteins are the body's building blocks. They play several roles, from repairing tissues to producing enzymes and hormones. However, for those with CKD, managing protein intake becomes a delicate balancing act. While protein is vital, consuming excessive amounts can strain the kidneys.
Typically, individuals with CKD are recommended to limit protein intake to no more than 0.8 grams per kilogram of body weight, though that can change based on other health concerns like cancer or diabetes. Not all protein source or potassium levels, which can be harmful. In contrast, some plant proteins, like chickpeas, may easier on the kidneys due to their lower phosphorus ad potassium content.
Balancing Exercise and Protein
Mixing exercise with protein intake should be done carefully. If you have questions about how much protein is right for you, you should ask your nephrologist or dietitian (that's what we're here for!).
When beginning a new exercise routine, start slowly and gradually increase your activity level as recommended by your physicians. Physical activity stimulates protein metabolism, aiding in muscle maintenance and muscle growth. Regular monitoring of kidney function through lab tests can track how your body responds to lifestyle changes.

The Role of Hydration
Hydration is crucial for managing CKD and exercising. While staying hydrated is vital, those with CKD may have specific fluid restrictions based on the disease stage.
When exercising, listen to your body. Recognize signs of dehydration and be mindful of your fluid intake to ensure safety. Always discuss with your healthcare provider to determine a suitable fluid intake level based on your health status.
Tips for Getting Started
Consult Your Healthcare Team: Before starting any exercise or diet changes, discuss your plans with your healthcare providers to create a safe plan.
Choose Enjoyable Activities: Engage in activities you enjoy. Whether it’s dancing, biking, weight lifting, or yoga, finding joy in physical activity can make consistency easier.
Set Realistic Goals: Begin with achievable goals. Setting small milestones keeps you motivated without feeling overwhelmed.
Opt for Quality Protein: Focus on whole food protein sources and try to limit highly processed meats like luncheon or breakfast meat. Lean meats, fish, and some plant-based proteins provide benefits without excessive strain on the kidneys.
Stay Consistent: Consistency is crucial in both exercise and diet. Focus on long-term lifestyle changes instead of seeking immediate results.
Taking Control of Your Health Journey
Living with chronic kidney disease is complex, but incorporating physical activity into your routine can significantly improve health. Individual needs may vary, but finding the right balance and staying informed can empower you to take control of your kidney disease.
With guidance from your healthcare team, embracing exercise and mindful protein intake can enhance kidney function and overall well-being. Remember, every small effort contributes to your long-term health!
Better health is possible when living with CKD. So, lace up those walking shoes or dig out your old bike and take charge of your health!
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