Abstract
The presence of chronic kidney disease（CKD）in peripheral artery disease（PAD）patients is associated with higher morbidity and mortality rates. This review focuses on the importance and efficacy of rehabilitation for CKD patients. Patients with CKD on hemodialysis（HD）have a high mortality with cardiovascular diseases, such as chronic heart failure, and a higher mortality risk has been reported for sedentary HD patients. A new systematic review and meta-analysis of randomized controlled trials reported that exercise-based renal rehabilitation improved aerobic capacity, muscular function, cardiovascular function, walking capacity, and health-related quality of life in CKD patients with HD. Moreover, exercise training may have renal protective effects not only in some animal models of pre-HD CKD, but also in pre-HD CKD patients. Exercise therapy may be an effective clinical strategy to improve renal function and reduce the need for renal replacement therapy, such as HD, or renal transplant risk in pre-HD CKD patients. The Japanese Society of Renal Rehabilitation was established to evaluate and promote renal rehabilitation in 2011, and Japan is the only country to offer exercise training that is covered by the national health insurance system for diabetic patients with pre-dialysis CKD（eGFR < 45 mL/min/1.73 m2）
