Key result
An 8-week cardiopulmonary rehabilitation program in a patient with severe heart and renal failure improved peak VO2 from 10.2 to 13.0 ml/kg/min and reduced required dialysis sessions from 21 to 4 per week.
Why the study?
Does exercise rehabilitation improve clinical and physiological outcomes in a patient with severe heart failure and renal failure on peritoneal dialysis?
Case Report (n=1)
No
Does exercise rehabilitation improve clinical and physiological outcomes in a patient with severe heart failure and renal failure on peritoneal dialysis?
Cardiopulmonary rehabilitation in a patient with severe heart failure and renal failure on peritoneal dialysis improved exercise capacity, cardiac function, and significantly reduced the need for dialysis.
May support cardiopulmonary rehab in severe HF with renal failure; single case leaves open need for controlled trials before practice change.
Heart failure is associated with high mortality and significantly reduced exercise capacity in many cases, despite medical treatment. Patients may present also renal failure, one of the most important comorbidities, which contributes even more to a poor prognosis, especially in patients who are already attending dialysis sessions1. Reduction of renal function occurs in approximately 25% of patients with chronic heart failure, regardless the severity of left ventricular dysfunction1. Exercise training is formally recommended as a safe non-pharmacological intervention in stable heart failure2,3. Nevertheless, many patients in severe stage are extremely symptomatic and consider themselves as incapable to attend an exerce training program. The association of heart failure and renal failure in use of continuous ambulatory peritoneal dialysis makes this attendance even more complicated. The physicians also are insecure and resistant to recommend cardiopulmonary rehabilitation for a patient with such important impairment. This case report aims at describing the clinical and physiological effects of an exercising program in a severe heart failure patient with renal failure in peritoneal dialysis.
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Hossri et al. (2014) conducted a case report in Heart failure and chronic renal failure (n=1). Cardiopulmonary rehabilitation vs. Baseline (pre-rehabilitation) was evaluated on Peak VO2 (ml/kg/min). An 8-week cardiopulmonary rehabilitation program in a patient with severe heart and renal failure improved peak VO2 from 10.2 to 13.0 ml/kg/min and reduced required dialysis sessions from 21 to 4 per week.
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