Nephrology Center, Toranomon Hospital, Tokyo 105-8470, Japan.
Nutrients. 2021 Apr 24;13(5):1444. doi: 10.3390/nu13051444.
With the growing number of dialysis patients with frailty, the concept of renal rehabilitation, including exercise intervention and nutrition programs for patients with chronic kidney disease (CKD), has become popular recently. Renal rehabilitation is a comprehensive multidisciplinary program for CKD patients that is led by doctors, rehabilitation therapists, diet nutritionists, nursing specialists, social workers, pharmacists, and therapists. Many observational studies have observed better outcomes in CKD patients with more physical activity. Furthermore, recent systematic reviews have shown the beneficial effects of exercise intervention on exercise tolerance, physical ability, and quality of life in dialysis patients, though the beneficial effect on overall mortality remains unclear. Nutritional support is also fundamental to renal rehabilitation. There are various causes of skeletal muscle loss in CKD patients. To prevent muscle protein catabolism, in addition to exercise, a sufficient supply of energy, including carbohydrates, protein, iron, and vitamins, is needed. Because of decreased digestive function and energy loss due to dialysis treatment, dialysis patients are recommended to ingest 1.2-fold more protein than the regular population. Motivating patients to join in activities is also an important part of renal rehabilitation. It is essential for us to recognize the importance of renal rehabilitation to maximize patient satisfaction.
随着衰弱的透析患者人数不断增加，肾脏康复的概念，包括针对慢性肾脏病（CKD）患者的运动干预和营养计划，最近变得流行起来。肾脏康复是一个由医生、康复治疗师、饮食营养师、护理专家、社会工作者、药剂师和治疗师共同领导的 CKD 患者综合多学科项目。许多观察性研究发现，身体活动较多的 CKD 患者有更好的结局。此外，最近的系统评价表明，运动干预对透析患者的运动耐量、身体能力和生活质量有有益影响，但对总体死亡率的有益影响尚不清楚。营养支持也是肾脏康复的基础。CKD 患者存在多种骨骼肌丢失的原因。为了防止肌肉蛋白分解，除了运动外，还需要充足的能量供应，包括碳水化合物、蛋白质、铁和维生素。由于透析治疗导致消化功能下降和能量损失，建议透析患者摄入比普通人群多 1.2 倍的蛋白质。激励患者参与活动也是肾脏康复的重要组成部分。我们必须认识到肾脏康复的重要性，以最大限度地提高患者的满意度。
