Aquatic Exercises for Chronic Kidney Disease

A 10 year follow-up study concluded: low-intensity aqua aerobic exercise program may slow down or halt the progression of chronic kidney disease

By Pechter U., Raag M., Ots-Rosenberg M. from the Departments of Internal Medicine for Public Health, Tartu University, Estonia, Sep 2014

About Chronic Kidney Disease (CKD)

Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.

Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.


The Study

Chronic kidney disease patients not yet in dialysis can benefit from increased physical activity; however, the safety and outcomes of aquatic exercise have not been investigated in observational studies.

The aim of this study was to analyze association of 10 years of regularly performed aquatic exercise with the study endpoint – that is, all-cause death or start of dialysis.

Consecutive chronic kidney disease patients were included in the study in January 2002. The aquatic exercise group (n=7) exercised regularly under the supervision of physiotherapist for 10 years; the control group (n=9), matched in terms of age and clinical parameters, remained sedentary.

Low-intensity aerobic aquatic exercise program was performed regularly twice a week; 32 weeks or more of exercise therapy sessions were conducted annually.

None of the aquatic exercise group members reached dialysis or died during the 10 years study. However, in the control group, only 55% reached the study endpoint, two members needed renal replacement therapy and three members have died.

Occurrence of the study endpoint, compared using the exact multinomial test with unconditional margins, was statistically significantly different (P-value: 0.037) between the study groups.

Regular supervised aquatic exercise arrested chronic kidney disease progression. There was a statistically significant difference between the sedentary group and the exercise group in reaching renal replacement therapy or all-cause death in a follow-up time of 10 years.



  1. International Journal of Rehabilitation Research: September 2014 – Volume 37 – Issue 3 – p 251–255
  2. PMID: 24859430
  • Mayo Clinic