Authors : Karthika Ramalingam; Geethapriya Vadamalai; Krishnan Saravanan; Manisha Jaisankar; P. Archana; Ragavi S.; Mohammed Bilal Iliyas

Volume/Issue : Volume 11 - 2026, Issue 7 - July

Google Scholar : https://tinyurl.com/2h46de92

Scribd : https://tinyurl.com/2s4z92da

DOI : https://doi.org/10.38124/ijisrt/26jul1774

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Abstract : Background: Chronic kidney disease (CKD) is a progressive condition associated with reduced kidney function, fatigue, decreased exercise tolerance, impaired quality of life, and multiple comorbidities. Patients undergoing maintenance hemodialysis frequently experience physical deconditioning and functional limitations. Exercise-based physiotherapy interventions have been increasingly recommended as an adjunctive treatment to improve overall health outcomes in this population.  Case Presentation: A 56-year-old male field worker with a history of bilateral renal calculi surgery, longstanding hypertension, major polytrauma with multiple fractures, and poor hydration habits presented with breathlessness, vomiting, severe fatigue, and progressive decline in kidney function. Laboratory investigations revealed hemoglobin of 6 g/dL and serum creatinine of 13 mg/dL, leading to the diagnosis of end-stage kidney disease requiring hemodialysis. Initially, dialysis was performed through a central venous catheter, followed by creation of a left upper-limb arteriovenous fistula for maintenance hemodialysis twice weekly. Persistent fatigue and reduced quality of life prompted referral for physiotherapy.  Intervention: An eight-week physiotherapy program consisting of diaphragmatic breathing exercises, upper- and lower-limb stretching exercises, and low-intensity mobility exercises was performed four days per week on non-dialysis days, with morning and evening sessions. Exercise intensity was modified according to fatigue levels.  Outcome Measures: Fatigue Assessment Scale (FAS) and Kidney Disease Quality of Life (KDQOL) questionnaire were assessed before and after intervention.  Results: Following eight weeks of supervised physiotherapy, the patient demonstrated reduced fatigue scores and improved quality of life, with better tolerance to activities of daily living and reduced perception of exhaustion. Conclusion: An individualized physiotherapy program performed on non-dialysis days may improve fatigue and quality of life in patients with CKD undergoing maintenance hemodialysis. Early incorporation of physiotherapy should be considered as part of multidisciplinary renal rehabilitation.

Keywords : Chronic Kidney Disease, Hemodialysis, Physiotherapy, Fatigue, Quality of Life, Renal Rehabilitation, Case Report.

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