We describe our experience with a patient who underwent KAATSU training combined with branched-chain amino acid (BCAA) intake after a Bentall procedure performed for aortic dissection associated with Marfan syndrome. This 33-year-old man experienced a waxing and waning postoperative course, with multiple complications including reoperation and subsequent severe disuse syndrome. In addition to conventional rehabilitation with bed-mobility and muscle-strengthening training, we prescribed KAATSU training combined with BCAA intake. Before training, it was difficult for the patient to get out of bed. However, after the KAATSU training, he exhibited gradual improvements in knee extension strength, skeletal muscle index, and quadriceps muscle thickness. His walking ability recovered to an independent level, and although he still had right upper limb paralysis and mild aphasia, he was eventually able to return to work. KAATSU training allows patients to improve their physical function safely and enables them to return to society even after serious cardiovascular surgery.

[Objective] To evaluate the efficacy and safety of KAATSU training via remote guidance over three months on body composition, muscle strength, and quality of life (QOL) in a patient who underwent nephrectomy for renal cell carcinoma (RCC).

[Methods] The subject was a female pianist in her 40s who was diagnosed with stage 3A (T3A) renal cell carcinoma and underwent left nephrectomy on April 10, 2024. Approximately 5 months postoperatively, she began a 3-month remote KAATSU program combining upper and lower limb exercises. Pre- and post-intervention assessments included body composition analysis, handgrip strength measurement, medical safety serum markers (creatinine, CPK, CRP), and QOL evaluation using the SF-36.

[Results] Training was completed safely without adverse events, as medical markers remained stable. Body weight increased significantly (from 47.7 kg to 48.8 kg, p=0.001), and fat-free mass similarly increased (from 34.4 kg to 35.5 kg, p=0.001). Skeletal muscle mass (SMM) increased significantly in the left arm, right arm, and right leg. Grip strength showed no significant change. Physical function (SF-36) showed slight improvement, but clinically declines (≥10 points) were observed in the subscales for physical role, emotional role, and mental health.

[Conclusion] Remote KAATSU training was demonstrated to be a safe and effective strategy for improving body composition and suppressing muscle mass loss in stage 3A renal cell carcinoma patients under strict dietary restrictions. However, the decline in mental QOL subscales suggests that the significant effort required for lifestyle changes (diet and exercise) after cancer treatment may impose psychological burden on patients, necessitating further consideration in rehabilitation protocols. This is the first case report detailing the application of KAATSU training in renal cell carcinoma patients.