How Much Exercise Is Right for You with PKD? | PKD Lifestyle
People living with polycystic kidney disease (PKD) often ask, "How much exercise is safe for me?" The answer depends on your stage of kidney disease, symptoms, and energy levels. The good news is that regular physical activity is beneficial at every stage of PKD. Whether you're newly diagnosed or receiving dialysis, exercise can improve your strength, energy, physical function, and quality of life. Here is how to safely approach exercise as PKD progresses.
How to Approach Exercise at Every Stage of PKD
People living with PKD should aim to follow the same physical activity guidelines recommended for all adults, while adapting their exercise routine to their symptoms, kidney function, energy levels, and overall health. For most adults, the long-term goal is to gradually work toward 150 minutes of moderate-intensity aerobic activity each week, along with strength training at least twice per week and regular balance and flexibility exercises.
As PKD progresses, your exercise goals may shift. In the earlier stages, the focus is on building fitness and establishing healthy habits, while in the later stages, the emphasis becomes maintaining strength, mobility, independence, and quality of life.
Stage 1-2 (eGFR 60 or higher)
Aim for 150 minutes of moderate-intensity aerobic exercise each week, along with strength training and balance exercises at least twice per week. Most people can tolerate the full physical activity recommendations.
Stage 3 (eGFR 30 to 59)
Continue working toward 150 minutes of aerobic activity each week, but consider accumulating exercise in shorter sessions (10–20 minutes), with additional recovery as needed. Continue strength and balance training twice per week.
Stage 4 (eGFR 15 to 29)
Aim for daily movement, accumulating 20–30 minutes of activity, even if this is broken into several short sessions, along with strength and balance exercises twice per week as tolerated. Maintaining function becomes more important than reaching a specific number of minutes.
Stage 5 / dialysis (eGFR below 15)
Aim for 10–30 minutes of light aerobic activity, such as walking or stationary cycling, on most days as tolerated. Strength and flexibility exercises twice per week can help maintain muscle mass, mobility, and transplant readiness. For people receiving hemodialysis, intradialytic exercise (exercise performed during dialysis) is also beneficial if available and recommended by your healthcare team.
How to Safely Build Your Exercise Routine
If you're new to exercise, begin with 10 minutes of walking twice per week for 2–3 weeks. If this feels manageable, increase to either 10 minutes three times per week or 15 minutes two to three times per week. Continue increasing by either adding five minutes to each walk or adding one additional walk each week, but avoid increasing both at the same time. Once you are comfortably walking for 20–30 minutes most days, add strength training once or twice per week. Remember to include rest days and finish each workout feeling challenged rather than exhausted.
For most adults with PKD, working toward 150 minutes of moderate-intensity physical activity per week is an appropriate and achievable goal. While some people may choose to be more active and can safely exercise beyond this amount, there is currently no evidence that exercising more than the recommended guidelines slows PKD progression, reduces cyst growth, or delays kidney failure. The goal of exercise is not to push your body as hard as possible, but to build and maintain strength, fitness, and overall health in a way that is safe and sustainable.
When to Push and When to Rest
For most people living with PKD, doing too little is a much more common concern than doing too much. However, your body will usually tell you when it is time to slow down. As PKD progresses, particularly during Stages 3–5 or for people receiving dialysis, it is normal for energy levels to fluctuate from day to day. Instead of asking yourself, "Can I complete my planned workout today?" try asking, "What amount of movement is realistic for my energy level today?"
On days when your energy is higher, you may feel capable of completing a longer walk or full exercise session. On lower-energy days, exercise may mean reducing the duration or intensity of your workout, choosing a shorter walk, performing gentle stretching, or doing a few simple strength exercises. Regular physical activity can actually improve energy and reduce fatigue over time, so the goal is to work with your energy level rather than against it.
It is also important to recognize the signs that you may be doing too much. If fatigue lasts longer than 24 hours after exercise, or if you experience persistent muscle or joint pain, dizziness, chest pain, unusual shortness of breath, or difficulty recovering between workouts, it may be time to reduce the intensity or duration of your exercise. If you notice blood in your urine after exercise, stop exercising and contact your healthcare team.
A helpful guideline is that you should finish most exercise sessions feeling like you could have done a little more. Exercise should challenge your body, but it should not leave you feeling depleted for the rest of the day or unable to participate in your usual activities.
Final Thoughts
It is important to remember that progress is not measured solely by the number of minutes you exercise. You are making meaningful progress if walking the same distance feels easier, you recover more quickly after exercise, you have more energy throughout the day, or everyday activities such as climbing stairs, carrying groceries, or getting up from a chair become easier. Feeling more confident in your ability to be physically active is another important sign of improvement.
Everyone progresses at a different pace, and that is completely normal. The best exercise program is one that you can maintain consistently over time, as even small increases in physical activity can have significant benefits for your health, independence, and overall well-being.
About the Author
Katie Bakgaard, BKin, ACSM-CEP, is the Clinical Exercise Physiologist for the Transplant Wellness Program (TWP). With a background in cardiac rehabilitation, Katie specializes in supporting patients with chronic illness through exercise and wellness programming to help them build confidence in movement, stay active, and improve their overall quality of life.
More
- For more PKD-friendly fitness, wellness, movement, and everyday health resources, browse our PKD lifestyle blog.
- Try one of our PKD-friendly workouts on our YouTube channel.
- Watch the Transplant Wellness Team talk about their program, from our 2025 PKD Summit.
- Learn more about the Transplant Wellness Program.
- Watch this video about exercise and PKD, also from our 2025 PKD Summit.
References & Resources
1. Young, H.M.L.; Billany, R.E.; Graham-Brown, M.P.M.; Lightfoot, C.J.; March, D.S.; Smith, A.C.; et al. Physical Activity in Kidney Disease: Evidence and Implementation. Nature Reviews Nephrology. 2025;21:846–858. doi:10.1038/s41581-025-00999-2
2. Aucella, F. Physical Activity in ADPKD and CKD Patient. Giornale di Tecniche Nefrologiche e Dialitiche. 2015;27:204–209.
3. Reinecke, N.L.; Cunha, T.M.; Heilberg, I.P.; Higa, E.M.S.; Nishiura, J.L.; Neder, J.A.; Almeida, W.S.; Schor, N. Exercise Capacity in Polycystic Kidney Disease. American Journal of Kidney Diseases. 2014;64:239–246.
Villanego, F.; Naranjo, J.; Vigara, L.A.; Cazorla, J.M.; Montero, M.E.; García, T.; Torrado, J.; Mazuecos, A. Impact of Physical Exercise in Patients with Chronic Kidney Disease: Systematic Review and Meta-Analysis. Nefrología. 2020;40:237–252.