Volume 30, Issue 175, September 2026

The Role of Physical Activity and Exercise Training in Patients Undergoing Hemodialysis

Przemysław Iwański^1♦, Zuzanna Knap¹, Natalia Grzywacz¹, Anna Hejman¹, Aleksandra Mazur¹, Iga Chalimoniuk¹, Julia Mrowińska¹, Ali Kraziński², Julia Kałużna², Marcelina Zielińska¹

¹Poznan University of Medical Sciences: PUMS, Poznan Polska, Poland
²Wojewódzki Szpital im. Błogosławionego księdza Jerzego Popiełuszki we Włocławku, Poland

^♦Corresponding author
Przemysław Iwański, Poznan University of Medical Sciences: PUMS, Poznan Polska, Poland

ABSTRACT

Purpose: Patients undergoing hemodialysis experience muscle weakness and limited exercise ability, making it difficult to perform everyday activities. This article discusses the impact of physical activity and exercise training on these patients' physical function and health-related quality of life, as well as their potential preparation for kidney transplantation. Materials and Methods: We reviewed the selected literature available in PubMed/MEDLINE, the Cochrane Library, and Scopus. The search terms used for this review were: hemodialysis, physical activity, exercise training, and kidney transplantation. Most of the articles were systematic reviews, meta-analyses, randomized controlled trials, and clinical practice guidelines. Results: Exercise programs during dialysis sessions improved patients' functional ability and quality of life. Some studies also found small reductions in blood pressure and improvements in lipid levels among patients who exercised during dialysis. Results for dialysis adequacy and inflammation also differed across studies. Exercise did not appear to increase adverse-event rates. Patients awaiting kidney transplantation who exercised during dialysis sessions walked farther in the six-minute walk test than those who did not exercise during dialysis. Patients who exercised during dialysis sessions also showed improvements in handgrip strength and body composition measurements. Conclusions: Exercise customized to the patient’s condition, including training performed during dialysis sessions, could become a regular part of hemodialysis treatment. Making these programs more widely available will require trained staff, clear patient information, and practical delivery procedures.

Keywords: Hemodialysis; Exercise; Intradialytic Exercise; Quality of Life; Kidney Transplantation

Medical Science, 2026, 30, e187ms3970

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DOI: https://doi.org/10.54905/disssi.v30i175.e187ms3970

Published: 15 September 2026