Exercising safely with a fistula or PD catheter
Specific precautions for arteriovenous fistulas, tunnelled lines and peritoneal dialysis catheters during exercise.
Written by Professor Mohammed Mahdi Althaf
Medically reviewed by Professor Mohammed Mahdi Althaf, Consultant Nephrologist · 3 August 2026
Overview
Exercise is strongly encouraged on dialysis, but access sites need respect. A few simple rules let you train hard without risking your access.
Why it's done and who it helps
Anyone with a fistula, graft, tunnelled central line or peritoneal dialysis catheter who wants to train while losing weight.
Fistula and graft
- Light to moderate hand-grip and forearm work is generally fine and may help maturation, but check with your access team first.
- Avoid heavy loads carried in the crook of the arm, and avoid any tight strap or band over the access.
- Stop and seek advice for new pain, swelling, coolness of the hand or a change in the buzz (bruit).
Tunnelled lines
Avoid swimming and submersion, and avoid overhead loading that pulls on the exit site until healed.
Peritoneal dialysis catheter
- Train with the abdomen drained where possible.
- Avoid heavy crunches, sit-ups and maximal straining that raise abdominal pressure, to reduce hernia and leak risk.
- Keep the exit site dry and clean after sessions.
Preparing for your appointment
Can I exercise on a dialysis day?
Many people prefer non-dialysis days or the first half of a dialysis day; both can work.
Is walking enough?
Walking is valuable but does not protect muscle as well as resistance work.
When to contact your care team
Contact the clinic promptly if you have any of the following:
- Vomiting or diarrhoea lasting more than 24 hours, or you cannot keep fluids down
- Passing much less urine than usual, or new swelling of the legs or face
- Severe pain in the upper abdomen that spreads through to your back
- A weight change of more than 2 kg in a week that is not explained by fluid
- A missed weekly weight, a missed dose, or any hospital admission
If you are seriously unwell, contact NHS 111 or your renal unit directly rather than waiting for your next review.
Your care at KidneyWeight Clinic
Every dose change, weekly weight and kidney blood test is recorded in your clinical monitoring record, reviewed by Professor Mohammed Mahdi Althaf at six-weekly intervals and formally reassessed at 26 weeks. Booking and your initial payment are handled by professoralthaf.co.uk, medication supply by Healist Pharmacy, and follow-up appointment payments by Carebit.