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基于诊所和家庭的肾脏康复改善血液透析患者的标准化Kt/V和尿毒症综合征:病例报告

Clinic- and home-based renal rehabilitation improves spKt/V and uremic syndrome in hemodialysis patients: a case report.

作者信息

Xie Danshu, Wu Chaolun, Yao Lu, Zhu Qin, Lu Jianxin, Ding Wei

机构信息

Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, PR China.

Department of Rehabilitation, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China.

出版信息

BMC Nephrol. 2025 Apr 11;26(1):187. doi: 10.1186/s12882-025-04102-6.

Abstract

There was an increasing uptake of hemodialysis and patient life expectancy due to improved treatment efficiency. However, the quality of life (QOL) of chronic kidney disease (CKD) patients is not parallelly improved, leading to a shift in focus towards promoting the QOL. Among the common complications of CKD such as anaemia and mineral bone disorder, uremic syndrome has been found as the main contributor to poor QOL. We present the case of an 80-year-old man with hemodialysis, who presented with poor appetite and weakness following recovering from COVID-19. Biochemical, echocardiographic, body composition, psychological, nutritional, and QOL assessments suggested multi-organ dysfunction attributable to uremic syndrome. Renal rehabilitation involving the combination of clinic- and home-based exercise and nutritional interventions effectively improved his symptoms while elevating spKt/V. Our case report not only demonstrated exercise and nutritional rehabilitation as an effective approach to managing uremic syndrome in hemodialysis patients, but also provided insight into the effects of improved nutritional status on spKt/V.

摘要

由于治疗效率提高,血液透析的使用率和患者预期寿命都在增加。然而,慢性肾脏病(CKD)患者的生活质量(QOL)并未得到同步改善,这导致关注点转向提高生活质量。在CKD的常见并发症如贫血和矿物质骨 disorder 中,尿毒症综合征已被发现是导致生活质量差的主要因素。我们报告了一例80岁接受血液透析的男性患者,他在从 COVID-19 康复后出现食欲减退和虚弱。生化、超声心动图、身体成分、心理、营养和生活质量评估表明多器官功能障碍归因于尿毒症综合征。包括门诊和家庭锻炼及营养干预相结合的肾脏康复有效地改善了他的症状,同时提高了 spKt/V。我们的病例报告不仅证明了运动和营养康复是管理血液透析患者尿毒症综合征的有效方法,还提供了关于营养状况改善对 spKt/V 影响的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb65/11987303/d9eeb5ea54e7/12882_2025_4102_Fig1_HTML.jpg

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