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心脏康复计划对心血管疾病患者肾功能的一年随访影响

Influence of a Cardiac Rehabilitation Program on Renal Function in Patients With Cardiovascular Disease in a One-Year Follow-Up.

作者信息

Fujimi Kanta, Miura Shin-Ichiro, Matsuda Takuro, Fujita Masaomi, Ura Yoshiyuki, Kaino Kouji, Sakamoto Maya, Horita Tomoe, Arimura Tadaaki, Shiga Yuhei, Saku Keijiro

机构信息

Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.

Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan; Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka, Japan.

出版信息

Cardiol Res. 2015 Oct;6(4-5):311-315. doi: 10.14740/cr440e. Epub 2015 Oct 25.

Abstract

BACKGROUND

Exercise training may improve renal function in patients with chronic kidney disease (CKD). The effect of cardiac rehabilitation (CR) with exercise training on renal function has not yet been established. We evaluated the effects of CR on renal function in patients with cardiovascular disease (CVD).

METHODS

Twenty-three CVD patients in a 1-year CR program (CR group) who had ischemic heart disease (IHD) and/or heart failure were compared with 26 age- and gender-matched CVD patients without CR (non-CR group, standard pharmacological care alone). At baseline and after 1 year, urea nitrogen (UN), creatinine (Cr), potassium (K), estimated glomerular filtration rate (eGFR) and hematocrit (Hct) in blood were assessed.

RESULTS

There were no differences in the patient characteristics at baseline between the CR and non-CR groups except for the percentages of heart failure and the use of calcium channel blocker. After 1 year, there were no significant changes in UN, Cr, K, eGFR or Hct in either the CR or non-CR groups. The patients in the CR group were divided into two groups according to the eGFR level at baseline: low (n = 12, eGFR < 51 mL/minute/1.73 m, indicating mild-to-moderate CKD) and high (n = 11, eGFR ≥ 51 mL/minute/1.73 m) eGFR groups. Although there were no differences in the patient characteristics at baseline between the low and high eGFR groups, the low eGFR group showed a significant increase in eGFR after the 1-year CR program.

CONCLUSIONS

CR may improve renal function in patients with mild-to-moderate CKD.

摘要

背景

运动训练可能改善慢性肾脏病(CKD)患者的肾功能。心脏康复(CR)联合运动训练对肾功能的影响尚未明确。我们评估了CR对心血管疾病(CVD)患者肾功能的影响。

方法

将23例参加为期1年CR项目(CR组)的患有缺血性心脏病(IHD)和/或心力衰竭的CVD患者与26例年龄和性别匹配但未接受CR的CVD患者(非CR组,仅接受标准药物治疗)进行比较。在基线和1年后,评估血液中的尿素氮(UN)、肌酐(Cr)、钾(K)、估计肾小球滤过率(eGFR)和血细胞比容(Hct)。

结果

除心力衰竭百分比和钙通道阻滞剂的使用情况外,CR组和非CR组在基线时的患者特征无差异。1年后,CR组和非CR组的UN、Cr、K、eGFR或Hct均无显著变化。CR组患者根据基线时的eGFR水平分为两组:低eGFR组(n = 12,eGFR < 51 mL/分钟/1.73 m²,提示轻度至中度CKD)和高eGFR组(n = 11,eGFR≥51 mL/分钟/1.73 m²)。虽然低eGFR组和高eGFR组在基线时的患者特征无差异,但低eGFR组在为期1年的CR项目后eGFR显著升高。

结论

CR可能改善轻度至中度CKD患者的肾功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f17/5295569/1cee9f7535a0/cr-06-311-g001.jpg

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