Exercise therapy during hospitalization for a pediatric patient with active IgA nephropathy: A case report

Abstract

Exercise therapy for pediatric patients with active IgA nephropathy is necessary to improve physical mobility functioning and maintaining a normal daily and school-life, whilst managing the risk of further relapse; although, this has not been investigated yet. This case report aimed to evaluate the influence of exercise therapy in a pediatric patient with active IgA nephropathy whilst being treated in-hospital with a multiple-drug combination therapy. The patient was an 18-year-old girl diagnosed with IgA nephropathy a year prior to her admission at the hospital for multiple-drug combination therapy. Moderate-intensity exercise therapy was started on the 8th day and continued until the 31st day, at discharge. The results of her physical functioning on the 8th and 30th day were grip strength from 21.1 kg to 21.0 kg, knee extension strength from 0.59 kgf/kg to 0.74 kgf/kg, skeletal muscle mass index from 7.2 kg/m2 to 6.7 kg/m2, 6-minute walk test from 570 m to 590 m, and peak work rate from 100 watts to 110 watts. Muscle strength and exercise tolerance were maintained, or improved. The urine protein/creatinine ratio (UP/Cr) from the 8th day to discharge decreased from 0.4 g/gCr to 0.2 g/gCr. There was no recurrence of IgA nephropathy during hospitalization. Exercise therapy during hospitalization in a pediatric patient with active IgA nephropathy may not have adverse effects, and may prevent a decline in physical function and exercise tolerance.