| [ Summary ] |
This review focuses on the importance and efficacy of rehabilitation for patients with chronic kidney disease (CKD). Patients with CKD on hemodialysis (HD) have very high mortality with cardiovascular diseases such as chronic heart failure, and higher mortality risk has been reported for sedentary HD patients. A recent systematic review and meta-analysis of randomized controlled trials reported that exercise-based renal rehabilitation improved aerobic capacity, muscular and cardiovascular function, walking capacity, and health-related quality of life (QOL) in patients with CKD on HD. Moreover, exercise training may have renal protective effects not only in some animal models of pre-HD CKD but also in pre-HD CKD patients. 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 patients with CKD. In 2011, the Japanese Society of Renal Rehabilitation was established to evaluate and promote renal rehabilitation. Moreover, Japan is the only country that offers exercise training for patients with diabetes and pre-dialysis CKD stage 4-5 that is covered by the national health insurance system. |