The Japanese Journal of Clinical Dialysis Vol.30 No.10(5)

Theme Individualized treatment and care for elderly dialysis patients
Title Aging, disabilities and frailty in CKD patients
Publish Date 2014/09
Author Misa Miura Course of Physical Therapy, Department of Health, Tsukuba University of Technology
Author Osamu Ito Internal Medicine and Rehabillitation Science, Tohoku University of Medicine
[ Summary ] Hemodialysis (HD) patients exhibit lower levels of fitness along with various structural, metabolic, and functional abnormalities due to uremic induced changes in skeletal muscles. The exercise capacity of HD patients declines independently of the extent of renal dysfunction. Furthermore, patients undergoing hemodialysis are at high risk of falls, with subsequent complications including fractures, loss of independence, hospitalization, and institutionalization. Aerobic and resistance exercise are beneficial not only in terms of improving physical functioning including maximal oxygen uptake and muscle strength, but also in improving anthropometrics, nutritional status, hematological indexes, inflammatory cytokine levels, depression, and health-related quality of life. Recently, interventions during hemodialysis sessions have become more popular and have been shown to be safe. It is time we incorporate exercise into the routine care of HD patients. However, the determination of an optimal exercise regimen or regimens according to patients' characteristics and needs is still necessary to facilitate implementation of exercise programs.
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