| [ Summary ] |
Chronic kidney disease (CKD) is a worldwide public health problem. This review focuses the importance and efficacy of rehabilitation for CKD patients. Patients with CKD and receiving hemodialysis (HD) have very high mortality rates. Cardiovascular diseases such as chronic heart failure and higher mortality risk factors have been reported for sedentary HD patients. A new systematic review and meta-analysis of randomized controlled trials have indicated that exercise-based renal rehabilitation improved aerobic capacity, muscular functioning, cardiovascular function, walking capacity, and health-related quality of life for CKD patients with HD. Moreover, exercise training may have renal protective effects not only as exhibited in some animal models of pre-HD CKD conditions but also in pre-HD CKD patients. Exercise therapy may be an effective clinical strategy to improve renal function and lower renal replacement therapy such as HD or renal transplant risk for pre-HD CKD patients. A decision was made by the Ministry of Health, Labor and Welfare Japan to extend RR partial coverage to include stage four pre-HD CKD patients for the first time worldwide in 2016. |