**7. Final Remarks**

The balance between muscle mass synthesis/breakdown is essential for the normal function of the muscle, which is partly regulated by ROS. More research is accumulating regarding the impact of redox imbalance in the process of muscle wasting, even though the exact mechanisms are still to be determined. Moreover, the potential influence of exercise on the attenuation of muscle wasting in CKD patients appears to be gaining points. However, it is urgent that worldwide exercise programs be implemented to better solidify the existing results to date. Although numerous dialysis patients may appear too frail and incapable of engaging in exercise sessions, those who do it have experienced the benefits [214]. In these cases, less vigorous exercise offers value, and these types of adaptations will help to gradually lessen some clinicians' misconceptions of exercise as a potential contraindication to the patients' health [214]. Furthermore, besides the compelling evidence of the health benefits, there may also be impactful advantages to the healthcare systems, by reducing collateral costs of CKD patients, such as interventions associated with disease complications. More and more, we believe that the cost savings in the long-term probably overcome the financial limitations that are sometimes still imposed and impede the introduction of exercise programmes as routine in clinical units. Since CKD patients who undergo dialysis experience inevitable sedentary time during treatment, we encourage the implementation of intradialytic exercise interventions as a coadjutant therapeutic strategy to reduce or at least decelerate CKD-associated muscle wasting.

**Author Contributions:** Conceptualization: S.M., D.V.L. and J.L.V. Writing—Original Draft Preparation: S.M. drafted the manuscript with substantial contributions from D.V.L. and J.L.V. Writing—Review & Editing: D.V.L., L.A.B., A.F., A.C.S. and J.L.V. contributed with important intellectual content during manuscript drafting or revision and accept accountability for the overall work. All authors have read and agreed to the published version of the manuscript.

**Funding:** SM is supported by a Portuguese Foundation of Science and Technology (FCT) doctoral grant (SFRH/BD/07740/2020). The Research Center in Sports Sciences, Health Sciences and Human Development is funded by FCT (UID/04045/2020).

**Institutional Review Board Statement:** Not applicable.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** Not applicable.

**Conflicts of Interest:** The authors declare that there are no conflict of interest regarding the publication of this paper.
