循環器ジャーナル71巻3号

2023年07月発行

特集 心臓リハビリテーションのエビデンスを極める Ⅲ.各分野のトピックスを知る

腎臓リハビリテーションのトピックス

著者： 祖父江理¹

所属機関： ¹香川大学医学部循環器・腎臓・脳卒中内科

ページ範囲：P.436 - P.442

POINT
・CKD患者はフレイル・サルコペニアの有病率が高い．
・サルコペニアを有するCKD患者に対しては蛋白制限を緩和する．
・運動療法はCKD患者において腎保護効果・生命予後改善効果を認める．

参考文献

1）Hamaguchi S, Tsuchihashi-Makaya M, Kinugawa S, et al. Chronic kidney disease as an independent risk for long-term adverse outcomes in patients hospitalized with heart failure in Japan. Report from the Japanese Cardiac Registry of Heart Failure in Cardiology（JCARE-CARD）. Circ J 2009 ; 73 : 1442-7.

2）Reese PP, Cappola AR, Shults J, et al. Physical performance and frailty in chronic kidney disease. Am J Nephrol 2013 ; 38 : 307-15.

3）Roshanravan B, Robinson-Cohen C, Patel KV, et al. Association between physical performance and all-cause mortality in CKD. J Am Soc Nephrol 2013 ; 24 : 822-30.

4）Kitada K, Daub S, Zhang Y, et al. High salt intake reprioritizes osmolyte and energy metabolism for body fluid conservation. J Clin Invest 2017 ; 127 : 1944-59.

5）Mandai S, Furukawa S, Kodaka M, et al. Loop diuretics affect skeletal myoblast differentiation and exercise-induced muscle hypertrophy. Sci Rep 2017 ; 7 : 46369.

6）日本腎臓学会サルコペニア・フレイルを合併したCKDの食事療法検討WG．サルコペニア・フレイルを合併した保存期CKDの食事療法の提言．日腎会誌2019 ; 61 : 525-56．

7）Sofue T, Okano Y, Matsushita N, et al. The effects of a participatory structured group educational program on the development of CKD : a population-based study. Clin Exp Nephrol 2019 ; 23 : 1031-8.

8）Eknoyan G, Lameire N, Eckardt KU, et al. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl 2013 ; 3 : 1-150.

9）日本腎臓リハビリテーション学会（編）．腎臓リハビリテーションガイドライン．南江堂，2018

10）Yamagata K, Hoshino J, Sugiyama H, et al. Clinical practice guideline for renal rehabilitation : systematic reviews and recommendations of exercise therapies in patients with kidney diseases. Ren Replace Ther 2019 ; 5 : 4.

11）Thompson S, Wiebe N, Padwal RS, et al. The effect of exercise on blood pressure in chronic kidney disease : A systematic review and meta-analysis of randomized controlled trials. PLoS One 2019 ; 14 : e0211032.

12）日本循環器学会，日本心臓リハビリテーション学会．2021年改訂版 心血管疾患におけるリハビリテーションに関するガイドライン．2021

13）Pescatello LS, Arena R, Riebe D, et al. ACSM's Guidelines for Exercise Testing and Prescription, 9th ed. Philadelphia : Wolters Kluwer/Lippncott Williams ＆ Wilkins, 2014

14）Billany RE, Vadaszy N, Bishop NC, et al. A pilot randomised controlled trial of a structured, home-based exercise programme on cardiovascular structure and function in kidney transplant recipients : the ECSERT study design and methods. BMJ Open 2021 ; 11 : e046945.