REVIEW – January 2003

Rehabilitation of patients with chronic renal failure


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Patients with chronic renal failure (CRF) are considered the highest risk group for atherosclerotic cardiovascular events. Proper preventive measures should be undertaken as early as possible to prevent premature atherosclerosis and the postpone further progression of the underlying renal disease. Physical inactivity is one of the major risk factors of atherosclerosis. However, CRF patients have usually limited exercise tolerance and individualized programmes are needed to encourage patients to promote their physical activity. Among non-pharmacological approaches aerobic exercise could be advised more often for CRF patients to increase their general conditioning and to stabilize renal function for longer period of time. Besides a wide variety of aerobic training possibilities, aquatic exercise is a novel approach in the CRF patients’ rehabilitation programme. Water immersion causes increase in renal blood flow and contributes to lowering of renal sympathetic nerve activity in the kidney, thus improving the aggravating effects of exercise on renal function. Complex rehabilitation service together with regular exercise, blood pressure control, dietary consulation, counselling for cessation of smoking, encouragement and education are essential component of the management of patients with CRF.