Regular physical activity and exercise can have many beneficial effects for dialysis patients. The provision of an opportunity for patients to exercise at their treatment center has several advantages, but almost any method of increasing activity is likely to be beneficial. In addition to in-center programs such as cycling exercise before or during dialysis, other exercise options include participation in community-based walking programs, water exercise or swimming, yoga, Tai Chi, or low-level strengthening programs. Physical therapy that is individualized to meet patients' needs is also especially appropriate for older persons. The essential condition is that the unit and staff are committed to a treatment culture that makes physical activity a priority. Asking patients what they are doing for regular exercise should be part of routine patient assessment.