[Recommendations for the rehabilitation of patients with chronic kidney disease requiring hemodialysis (literature review)].

Abstract

Chronic kidney disease (CKD) is a global health problem, CKD is widespread in the world, on average it is detected in 10-13% of the adult population. Sedentary patients with CKD on dialysis have a higher risk of mortality. Despite the significant association of physical function with mortality in patients with CKD, physical function is not routinely assessed and exercise is not a component of the routine management of patients with CKD on dialysis.

Objective: The purpose of this study was to evaluate the effectiveness of the influence of motor rehabilitation methods on the prognosis of patients with chronic kidney disease (CKD) using hemodialysis (HD) from the standpoint of evidence-based medicine according to a scientometric analysis of the literature.

Material and methods: An analysis was carried out of systematic reviews (search depth 70 years) and network meta-analyses to assess the effectiveness of physical exercise, its intensity and duration, performed interdialytic and intradialytic in the rehabilitation of patients with CKD with renal failure requiring hemodialysis. We reviewed articles in foreign journals on the PubMed, Embase, CINAHL, Web of Science, Wan Fang data, Cochrane CENTRAL and Scopus platforms.

Results: The use of different types of physical exercise with varying intensities and durations both during and outside of dialysis in CKD patients requiring hemodialysis has shown that aerobic exercise, resistance exercise and a combination of both are most effective in improving their physical condition and quality life. Meta-analyses provide evidence to support the value of intradialytic exercise compared with interdialytic exercise for dialysis patients. It is also noted that moderate-intensity exercise can be performed in various forms, both during and outside of dialysis, and the data studied demonstrate that moderate-intensity exercise best improves physical function.

Conclusion: Future large RCTs should pay more attention to rehabilitation and exercise programs for CKD patients requiring HD. To encourage inactive patients with CKD to engage in physical exercise, educating them about the effects of exercise is imperative. Accumulating evidence suggests that rehabilitation of patients with visceral disorders, such as renal, cardiac, and pulmonary disorders, can not only improve physical performance and quality of life, but also improve survival. Modern comprehensive rehabilitation of patients with CKD is aimed at prolonging life, which represents a new concept in renal rehabilitation.