-Original-

Impact of Home-Based Rehabilitation on Renal Prognosis in Patients with Chronic Kidney Disease

Ayako Ikenouchi¹, Yukinao Sakai¹, Shouhei Wada², Yorito Yanagida², Tetsuya Kashiwagi¹ and Masato Iwabu¹

¹Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
²IKIIKI SUN Visiting Nursing Rehabilitation Station, Tokyo, Japan

Background: The increasing prevalence of chronic kidney disease (CKD) requires effective preventive measures, particularly due to an aging population. This study aimed to assess the effectiveness of home visit rehabilitation in preventing renal function decline among patients with CKD.
Method: In this retrospective study, patients with non-dialysis CKD undergoing home visit rehabilitation were compared with those receiving outpatient care at the Nippon Medical School Hospital between August 2017 and August 2023. Patients' backgrounds were matched using propensity scores derived from a logistic regression model. The primary endpoint was the annual change in the estimated glomerular filtration rate (eGFR), and the secondary endpoint was the annual change in blood parameters (Δblood urea nitrogen, Δcreatinine, Δtotal protein, Δalbumin, ΔC-reactive protein, Δhemoglobin, and Δhematocrit). Furthermore, the incidence of clinical outcomes, including mortality, hospitalization rate, and dialysis initiation rate, were analyzed within the additional 1-year observation period.
Results: Overall, 128 patients (64 matched pairs) were analyzed. After a mean follow-up period of 12.7 ± 4.6 months, there was no significant difference in the eGFR between both groups (40.1 ± 13.7 vs. 37.8 ± 13.8 mL/min/1.73 m², p = 0.36), but the annual decline in eGFR (%/year) was significantly lower in the rehabilitation group (-1.1 ± 29.8% vs. -11.8 ± 27.7%/year, p = 0.037). The annual change in the level of each blood test parameter and clinical outcomes were not significantly different between the two groups.
Conclusion: Home-based rehabilitation interventions may mitigate the progression of renal impairment in patients with CKD.

J Nippon Med Sch 2024; 91: 439-445

Keywords
chronic kidney disease, home visit rehabilitation, renal rehabilitation, rehabilitation, renal prognosis

Correspondence to
Yukinao Sakai, Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
y-sakai@nms.ac.jp

Received, April 27, 2024
Accepted, June 17, 2024