慢性腎不全患者の運動と腎機能に関する研究 ： 嫌気性代謝域値相当運動負荷による影響

Abstract

This study evaluates exercise capacity and the effects of exercise on renal function of patients with chronic renal failure. Sixty-two patients with chronic nephritis were classified on the basis of serum creatinine level (Scr) into three groups : Group N₁, patients with Scr 1.4 mg/dl or less ; Group N₂, patients with Scr 1.5 to 2.4 mg/dl ; and Group N₃, patients with Scr 2.5 mg/dl or more. The patients were tested on a bicycle ergometer to determine their exercise capacity as measured by peak oxygen consumption(⩒o₂peak) and anaerobic threshold (AT) ; results were compared with those for ten normal controls. Groups N₁, N₂, and N₃ showed significantly lower exercise capacity than the controls. Group N₃ had significantly lower AT levels than Group N₁. Twenty-three patients were exercised on the ergometer for 10 minutes at a level approximating AT. In Group N₂, creatinine clearance (Ccr) during exercise was unchanged. In Group N₃, Ccr during exercise significantly decreased but returned to almost pre-exercise levels within 60 minutes. No changes in Ccr or urinary protein excretion were observed in twenty patients in Groups N₂ and N₃ following ergometer exercise for 15 minutes twice a day for 2 weeks at a level approximating AT. These findings suggest that exercise below the level of AT does not adversely affect renal function in patients with Scr of 2.4 mg/dl or less.