Background: People with end stage renal disease (ESRD) have been reported as having low levels of physical activity. Sedentary behaviours increase illness risks which may lead to burdens on the public health system which include costs of medical care. Research has established that exercise is reported to improve general health and wellbeing. Benefits include better aerobic tolerance, maintenance and improvement in physical function and capacity, and improvement in self-concept and well-being. These same improvements also occur in an exercising ESRD population, even though the improvements might be of less magnitude. Renal unit staff can have a major impact on patients with ESRD by actively promoting exercise. Purpose: The study surveyed renal units throughout Australia, to obtain information on exercise rehabilitation practices within these units. Method: This was a descriptive single cross sectional study of dialysis units within Australia. Each unit was asked what exercise rehabilitation practices were conducted in their units at a basic, intermediate and advanced level. The survey questionnaire was adapted from the Unit Self-Assessment Manual for Renal Rehabilitation (The Life Options Rehabilitation Advisory Council [LORAC] 1998). Results: Twenty-two units responded, a 52.38% return rate. On average, only 9% of the content of the education programs was related to exercise practices, and only 9% of units had organized fitness programs. Most of the education programs were related to diet and fluids, dialysis therapies, and vascular access care. 50% of units reported they regularly referred patients to occupational therapy and physiotherapy but the outcome of these referrals in terms of physical activity is unknown. Comments demonstrated that staff were aware of the importance of exercise, however many comments related to unmotivated patients and lack of resources (staff and finances) to support physical activity programs. Conclusion: The results of this study suggest that there is a real need to actively develop physical activity rehabilitation programs within Australian dialysis units. With the large amount of literature now available reporting the benefits of exercise in those with ESRD, an important consideration for renal physicians and nurses is their ‘duty of care’ to their patients to promote physical activity.