We have read with great interest the clinical brief article by Parker et al.1 regarding the reasons for nonparticipation in a sustained intradialytic exercise program. The authors showed that patients completed 57% of prescribed exercise sessions (509 of 900). The three most prevalent reported reasons from patients not exercising were refusal to participate, fatigue, and the presence of symptoms. Interestingly, the presence of a kinesiologist increased patient adherence to the exercise program two times more than sessions that had no kinesiologist.