慢性心腎不全のリハビリテーション 運動療法と心エコー検査に基づく体重調整によりＱＯＬが改善した１例

Abstract

A case is a man of 62 years old who had had hemodialysis for the last five years. He also suffered from contracted chronic glomerulonephritis, epilepsy, combined valvular disease, atrioventricular block, multiple cerebral infarctions and atrial tachycardia. He had the operation of aortic and mitral valves replacement and the implantation of cardiac pacemaker in the past. This time he developed heart failure, hypotention, and disuse syndrome as a complication after some days with difficulty to maintain adequate activities of daily living. His cardiac performance was minutely evaluated by echocardiography. Based on the evaluation result, the weight control program which regulated water intake and nutrition was conducted with watching upon his subjective symptoms and cardiac function. Furthermore, he practiced stretching and therapeutic exercise by bicycle ergometer. As a result, his subjective symptoms disappeared, and his quality of life (QOL), evaluated by KDQOL-SF™, improved. These results suggest that the appropriate rehabilitation including therapeutic exercise improves the QOL of a hemodialysis patient with both chronic heart failure and chronic renal failure.