For many people living with chronic kidney disease (CKD), fatigue, weakness, and loss of muscle strength can make even daily activities challenging, let alone preparing for a kidney transplant. But a unique program at Virginia Commonwealth University (VCU) is changing that through the power of exercise.

The Renal Rehab program, rooted in science and led by Dr. Danielle Kirkman, helps patients with CKD and end-stage kidney disease build strength, improve heart health, and prepare their bodies for transplant surgery.

The concept is simple but groundbreaking: using structured, safe exercise as a form of “prehab”, rehabilitation before surgery, to improve long-term outcomes and quality of life.*

From Dialysis to Determination

When Carol Bourne moved to Richmond, Virginia, she didn’t expect her life to change so suddenly. After learning that her kidneys had failed, she began dialysis several days a week and later transitioned to home treatments.

During a visit at VCU Health’s Division of Nephrology, she came across a brochure for Renal Rehab: a program designed specifically for people like her.

“As a younger person, I was a dancer,” Bourne said. “By the time I had kidney failure, I was pretty sedentary. Renal Rehab gave me the confidence and guidance I needed to move again safely.”

How the Program Works

Founded in 2021, Renal Rehab brings together specialists from exercise physiology, nephrology, and transplant medicine.

Patients attend sessions several times a week where they:

• Work with trained exercise science students to follow personalized fitness plans.
• Build strength and endurance through safe cardiovascular and resistance training.
• Receive nutrition counseling tailored to kidney health.
• Have vital signs monitored to ensure safety during exercise.

Most participants join before a kidney transplant to increase their eligibility and improve post-surgery recovery, though the program also supports patients managing CKD without surgery.

“Many people with CKD are told to exercise, but they don’t know where to start, and they’re often too tired or unsure how to do it safely,” Dr. Kirkman explained. “Renal Rehab provides the structure, safety, and encouragement they need.”

The Science Behind the Sweat

While patients see immediate physical and emotional benefits, the program’s foundation lies in years of research.

In her lab, Dr. Kirkman and her team study how exercise protects the blood vessels, which are often damaged by toxins that accumulate when kidneys don’t function properly. They’ve found that increased blood flow from physical activity helps stimulate healthy vessel function, improving circulation and protecting the heart.

The lab’s findings mirror what’s happening in the clinic: patients who participate in regular exercise have better cardiovascular health, stronger muscles, and improved recovery times after transplant.

A Model for the Future

The results have been so encouraging that the VCU team is collaborating with other researchers to adapt the model for patients with liver disease and other chronic conditions.

Renal Rehab is currently seeking funding and insurance coverage so more patients can participate. Similar cardiac and pulmonary rehab programs are already reimbursed by insurance, and the team hopes to make that true for kidney patients too.

“Exercise is medicine,” Dr. Kirkman said. “We want Renal Rehab to be accessible to everyone who could benefit from it.”

For Bourne, the impact has been life-changing. “It’s really done wonders for me,” she said. “It’s better than any other program I’ve been in, and I would recommend it highly. It gave me my strength, and my life back.”

Building More Than Muscle

Beyond the physical improvements, many participants describe Renal Rehab as a place of community and healing.

“Dr. Kirkman has been really great at building community,” Bourne shared. “It’s nurturing and welcoming. For people who’ve been sick for a long time, it makes a huge difference to be around caring, knowledgeable people.”

Why It Matters

CKD affects 1 in 7 adults in the U.S., and frailty often limits access to transplants. Programs like Renal Rehab show that with the right support, patients can reclaim strength, confidence, and independence, improving both survival and quality of life.

Have you found ways to stay active while managing CKD? Share your experience in the comments and inspire others seeking motivation to take the next step toward better health.

* VCU Health (November 7th, 2025). “Offering a Leg Up to Patients With Chronic Kidney Disease”. vcuhealth.org

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