腎不全と運動

—動物モデルでの成績を中心に—

抄録

The exercise capacity of the patients with renal dysfunction declines and this phenomenon is distinctly related to the extent of renal function deterioration. It is suggested that appropriate exercise training may improve the physical strength and the quality of life in patients with chronic renal failure(CRF)besides the improvement of glucose and lipid metabolism. However, it is required to consider the influence of exercise on renal function thoroughly, because acute exercise causes proteinuria and decreases renal blood flow and glomerular filtration rate. At present, there are few reports concerning the optimal intensity and duration of exercise training for patients with CRF. Moreover, there has been no definite conclusion as to whether or not chronic exercise training(EX)has any renal protective effect in animal models of CRF. Recently, the renal and peripheral effects of long-term moderate to intense exercise training in various rat models of CRF has been extensively reported. The effects of a combination of EX and rennin-angiotensin system inhibitors(ARI)on renal function were also assessed. The results indicated that moderate to intense EX and ARI can yield a renal protective effect in some models. They also suggested that the simultaneous treatment of moderate EX and ARI provided a greater renoprotective effect than treatment by ARI alone. Further investigations will be needed to examine the mechanism of the renal protective effect of EX. A better understanding of the mechanism may lead to improved exercise strategies and the establishment of a renal rehabilitation regime for CRF patients.