A research group led by Professor Junichi Hoshino of Tokyo Women's Medical University* conducted a nationwide multicenter collaborative study that followed 708 maintenance hemodialysis patients for three years and revealed that patients who received renal rehabilitation during dialysis had a better prognosis compared to those who did not.
Renal rehabilitation is a comprehensive program that combines exercise therapy, diet and fluid management, drug therapy, patient education, and psychological and social support by a multidisciplinary team to reduce the physical and psychological impact on patients with kidney disease and aim to improve their return to social life and long-term prognosis. However, the relationship between renal rehabilitation during dialysis and long-term life prognosis was unclear. Therefore, the research group conducted the "REVEAL-D study," which combined a 3-year retrospective study with a 5-year prospective study.
The 3-year follow-up study included 708 patients out of 2471 maintenance hemodialysis patients at 10 facilities nationwide: 228 patients who received renal rehabilitation during dialysis and 480 patients whose patient characteristics were combined. The results showed that the 3-year survival rate in the rehabilitation group was 84.6%, significantly better than the 75.6% in the non-rehabilitation group. Even after adjusting for various factors, the mortality risk in the rehabilitation group was lower. In addition, patients with regular exercise habits (at least twice a week for 30 minutes or more for at least one year) had a better prognosis than patients without regular exercise habits.
Currently, as part of the REVEAL-D study, a multicenter collaborative study is being conducted to prospectively evaluate exercise prescriptions, nutritional and lifestyle guidance, and adherence to these programs. In addition to verifying which patients, what content, and to what extent is most effective, the study also evaluates adverse events, hospitalization, physical function, quality of life, and health economics, including medical and nursing care costs. The goal is to establish a safe and sustainable renal rehabilitation system in dialysis facilities nationwide and to promote its international dissemination.
*Joint research institutions: St. Marianna University School of Medicine, International University of Health and Welfare, Hyogo College of Medicine, Showa University School of Medicine, Osaka Metropolitan University Graduate School, Aozora Clinic, Flexible Co., Ltd.
