The Japanese Journal of Clinical Dialysis Vol.34 No.12(5-1)

Theme Cure and care in dialysis wards heading for the year 2025 / Measures against fl oods and sediment disasters for dialysis wards
Title Renal rehabilitation in chronic kidney disease patients -- present status and future perspective
Publish Date 2018/11
Author Masahiro Kohzuki Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
[ Summary ] Individuals suffering from chronic kidney disease (CKD) deal with major morbidity and mortality including poor exercise tolerance. A variety of factors including anemia, poor muscle mass, cardiovascular changes, and limited physical activity contribute to exercise intolerance. This review focuses on the importance and the efficacy of exercise and sports for hemodialysis (HD) patients. Exercise-based renal rehabilitation (aerobic and resistance training) improved the aerobic capacity, muscular functioning, cardiovascular function, walking capacity, and health-related quality of life in CKD patients with HD. The current recommendation suggests individuals with HD should avoid collision sports. Special care must be taken to avoid infection or damage to the peritoneal dialysis catheter and hemodialysis vascular access sites. Moreover, exercise therapy could be an effective clinical strategy to improve renal function and lower renal replacement therapy such as HD or renal transplant risk in pre-HD CKD patients. The Japanese Society of Renal Rehabilitation was established to evaluate and promote renal rehabilitation in 2011 and Japan is the only country to offer exercise training for patients with diabetes and pre-dialysis CKD stage 3b-5 that is covered by the national health insurance system.
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