A pilot study to relationship between urinary protein excretion and muscle strengthening in patients with acute onset renal disease

Rehabilitation of a Patient With Minimal Change Nephrotic Syndrome and Acute Kidney Injury: A Case Report

Patients with minimal change nephrotic syndrome (MCNS) are prone to loss of motor skills due to urinary protein leakage, steroid myopathy, and other factors. Acute kidney injury (AKI) is a common complication that contributes to the loss of physical function. Rehabilitation is crucial, but its efficacy and safety are unknown. Here we present a case of a patient with MCNS complicated by AKI, who commenced rehabilitation after dialysis was discontinued and experienced improved mobility. The patient, a woman in her 70s, was admitted to our hospital with bilateral lower limb edema and decreased urine output for approximately 5 days. Treatment with prednisolone and furosemide was initiated, but then dialysis was initiated due to AKI. Rehabilitation was started after dialysis was discontinued. The patient's muscle strength and physical activity improved, and her exercise capacity and exercise tolerance improved without adverse effects. Rehabilitation may contribute to the improvement of exercise capacity without worsening renal function and urinary protein in patients with MCNS complicated by AKI.

Comparison of clinical outcomes following early rehabilitation in 3 cases of nephrotic syndrome with different treatment courses

There have been few published reports regarding rehabilitation for nephrotic syndrome. We compared the clinical outcomes of three cases of nephrotic syndrome with different treatment courses during 5 weeks of early rehabilitation.We report on three cases of nephrotic syndrome. Case 1 was a 67-year-old male who showed good progress after steroid treatment. Quadriceps torque and exercise capacity were increased after intervention. Case 2, a 78-year-old male, demonstrated resistance to steroid treatment. Quadriceps torque was decreased and exercise capacity was increased after intervention. Case 3 was an 83-year-old male who received nutrition therapy and diuretics without steroid treatment. Quadriceps torque and exercise capacity were decreased post-intervention.Early rehabilitation should be considered even if the steroid treatment course is different; furthermore, it is necessary to carefully consider the optimal exercise load in patients with nephrotic syndrome for whom regardless of whether or not steroid treatment is used.

Evaluation of the safety, effectiveness, and health-related QOL impact of early rehabilitation in patients with nephrotic syndrome

BACKGROUND

The aim of this study was to evaluate the safety, effectiveness, and health-related QOL impact of early rehabilitation in patients with nephrotic syndrome.

METHODS

Subjects consisted of 23 patients with nephrotic syndrome who had previously received steroid treatment. Patients worked performed quadriceps resistance training and aerobic training 5 days per week for 5 weeks. Urinary protein, albumin (Alb), creatinine (Cre), and blood urea nitrogen (BUN) were monitored once every week over a 5-week period based on medical records. The 36-item short form health survey (SF-36) score was used to evaluate health-related QOL.

RESULTS

There was no significant difference in quadriceps force and no significant effect of age as shown by ANCOVA. Anaerobic threshold (AT) and peak oxygen consumption (peak VO₂) both increased significantly. AT was affected by the degree of change in body weight according to ANCOVA. Cre and BUN were not significantly altered. Urinary protein showed a significant decrease and Alb was significantly increased. Only physical function (PF) in the SF-36 showed a significant improvement following the intervention.

CONCLUSION

Our data indicate that early rehabilitation involving quadriceps resistance training and aerobic training for nephrotic syndrome is safe and effective.