The Rehabilitation Role in Chronic Kidney and End Stage Renal Disease

Abstract

Chronic kidney disease (CKD) worldwide is rising markedly becoming a priority public health problem. The progression of CKD cause functional limitation and severe disability with poor quality of life. The aim of present review was to highlight the effect of rehabilitation in CKD and ESRD subjects. The rehabilitative process is unique in treating disabled people according to a holistic approach with the aim of supporting a person's independent living and autonomy. CKD are associated with an increased risk of functional impairment, independent of age, gender, and co-morbidities. Clinicians should counsel patients with CKD including frail elder people to increase physical activity levels and target that regular physical activity including aerobic or endurance exercises training benefits health. In old subjects with CKD and multiple functional impairments, the traditional disease based model should be changed to individualized patient-centered approach that prioritizes patient preferences. Patients receiving haemodialysis have a considerably lower exercise tolerance, functional capacity, and more muscle wasting than healthy subjects or patients with less severe CKD. Exercise training or comprehensive multi-dimensional strategy and goal-oriented intervention should be also provided in ESRD older subjects. Structured prevention programs based on reducing the risk factors for CKD and rehabilitative strategies could reduce disability occurrence.

Factors related to fatigue in Chinese patients with end-stage renal disease receiving maintenance hemodialysis: a multi-center cross-sectional study

“…1,2 In China, the largest developing country worldwide, the overall prevalence of CKD accounted for approximately 10.8%, which affected an estimated 119.5 million adults in China. 3 The incidence of ESRD was high and increasing rapidly, and mainland China has to face the huge burden of renal replacement therapy (RRT).…”

Effects of physiotherapy in patients treated with chronic hemodialysis

“…Patients with chronic renal failure have complex functional disorders and multiple clinical disorders which require an interdisciplinary approach and engagement of physiologists, geriatrician, nephrologists, other specialists, as well as nurses, social workers and professional physiotherapists [2]. In hemodialysis patients, in addition to muscle weakness, a serious problem is the low tolerance to exercise, which may result in increased cardiovascular risk, or even sudden death.…”

“…The progression of chronic kidney disease leads to functional constraints and severe disabilities connected to poor quality of life requiring an appropriate rehabilitation strategy. This is especially due to the fact that this population of patients has a greater number of comorbidities, which leads to an extremely sedentary lifestyle [2].…”

Physical function was related to mortality in patients with chronic kidney disease and dialysis

“…Exercise training may improve physical activity and increased physical activity can prevent muscle loss in patients with CKD. 16 A previous systematic review reported that exercise improves aerobic capacity, muscular functioning, cardiovascular function, walking capacity, and the healthrelated quality of life (QOL) in patients with CKD. [12][13][14] Exercise capacity in patients with dialysis is low compared to the age-predicted value.…”