The John Walls Renal Unit, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
Nephron Clin Pract. 2010;115(1):c7-c16. doi: 10.1159/000286344. Epub 2010 Feb 19.
Patients with advanced chronic kidney disease (CKD), especially those on long-term dialysis, often suffer from muscle wasting and excessive fatigue. It is known that inactivity, muscle wasting and reduced physical functioning are associated with increased mortality in CKD. Known causes include uraemic myopathy and neuropathy, inactivity, and anaemia. Exercise in patients receiving regular dialysis treatment for end-stage renal disease was first introduced 3 decades ago, but is still only offered in a minority of renal units around the world, despite a significant body of evidence to support its use. Work is needed to increase awareness of the potential benefits of increased physical activity for patients with advanced CKD. This review summarizes the mechanisms of exercise intolerance and debility in advanced CKD patients, the methods used for the estimation of functional capacity, the options currently available for exercise training, and their influence on the well-being of this group of patients.
患有晚期慢性肾脏病（CKD）的患者，尤其是长期接受透析治疗的患者，常常会出现肌肉萎缩和过度疲劳的情况。众所周知，活动能力下降、肌肉萎缩和身体功能降低与 CKD 患者的死亡率增加有关。已知的原因包括尿毒症性肌病和神经病、活动能力下降以及贫血。30 年前首次在接受终末期肾脏疾病常规透析治疗的患者中引入了运动，但尽管有大量证据支持其使用，但在全球范围内，只有少数肾脏单位提供这种治疗。需要开展工作来提高人们对增加体力活动对晚期 CKD 患者的潜在益处的认识。这篇综述总结了晚期 CKD 患者运动不耐受和虚弱的机制、用于估计功能能力的方法、目前可用于运动训练的选择以及它们对这群患者的幸福感的影响。
