Recommendations for implementation of physical training guidelines for patients undergoing chronic hemodialysis

The exponential growth in the prevalence of chronic kidney disease (CKD) is currently one of the greatest public health challenges worldwide, with a high economic impact at the health level and on the quality of life of affected patients. In countries with a low organ donation rate, hemodialysis is the renal replacement treatment par excellence. Although hemodialysis improves patient survival, in the medium and long term it generates a series of consequences and pathophysiological adaptations that gradually cause a significant reduction in general physical function, affecting daily activities and quality of life. The evidence of the beneficial effects of exercise in patients with any stage of chronic kidney disease, including those on dialysis therapy, is well known. Different types of physical training programs have shown to significantly improve the physical function of patients. The positive impact on clinical aspects such as mental health, hemodialysis efficacy as well as associated healthcare costs is significant. In Latin American countries, these programs are still at a very incipient level of development. The present work is a review of recommendations that should be considered for the implementation of a physical training program for patients on chronic hemodialysis