摘要
Chronic heart failure is increasingly prevalent worldwide and is associated with signifi cant morbidity and mortality.The Cochrane review demonstrated that cardiac rehabilitation(CR)resulted in improvements in QOL and a reduction in long-term mortality.Chronic kidney disease(CKD)is another worldwide public health problem.This review focuses on the importance and effi cacy of rehabilitation for CKD patients as a new target of CR.Patients with CKD on hemodialysis(HD)have a high mortality rate,with cardiovascular diseases,such as chronic heart failure.A new systematic review and meta-analysis of randomized controlled trials reported that exercise-based renal rehabilitation improved aerobic capacity,muscular functioning,cardiovascular function,walking capacity,and QOL in CKD patients with 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 in improving renal function,lowering the need for renal replacement therapy,such as HD,and reducing renal transplant risk in pre-HD CKD patients.This led the Ministry of Health,Labor and Welfare of Japan to extend renal rehabilitation partial coverage to stage4pre-HD CKD patients for the first time in the world in 2016.
