Renal Rehab

Question 1

RENAL: Intro

duration, phases (2), component (5)

dialysis x PT

benefit (6)

benefit: heart & lungs

Answer 1

• duration: 6-12w (phase 2), maintenance (phase 3)
• dialysis as main tx for end stage, PT address effect of dialysis

components
- exercise, diet & fluid, meds, education, psych

benefit
- heart & lungs
- lower blood pressure, inc O consumption
- dec blood sugar, dec weight

Question 2

RENAL: Indications

nephrosis/nephritis - define, pathology, PT goal (3), oral steroid precaution

dialysis therapy - purpose of dialysis, effect of dialysis, when tx (2)

kidney transplant - effect, tx consideration

Answer 2

NEPHROSIS
- nephrosis: syndrome of various diseases
- nephritis: inflamed kidney
- kidney can’t clean waste off blood
- PT: protein, sodium, potassium
- oral steroid = fx

DIALYSIS THERAPY
- helps filter blood when kidney can’t; inactivity
- tx: non-dialysis days, first half to avoid hypotension

KIDNEY TRANSPLANT
- inactivity
- tx: dec intensity

Question 3

RENAL: Guidelines

clearance, protocols (2)
range for x exercise, no what resistance

bruce, bruce, naughton - how, for

Answer 3

• clearance from nephrologist
• protocol: treadmill & cycle ergometer
• 60-180 isokinetic, NO isometric since valsava

treadmill protocols
- bruce modified 3 min: initially slow but fast progression; start at <10%; maximal
- bruce: fast; start at 10%; maximal
- naughton: dec progression & pace; for very symptomatic pts & conservative

Question 4

RENAL: Indications - Chronic Kidney Disease

stages x GFR (5) x RM

we don’t use what RM, holten curve (9)

Answer 4

stage 1 normal / high GFR
- GFR >90mL/min
stage 2 mild CKD
- GFR 60-89mL/min
stage 3 mod CKD
- A: GFR 45-69
- B: 30-44
stage 4 severe CKD
- 15-29
stage 5 end stage
- <15

RM
- stage 1-4: 3 as much as possible
- stage 5: 12-15
- we don’t use 1 RM (lift resistance only once)
- higher RM = easier
- holten curve: 100-60, 1 2 3 4 7 11 16 22 25 30

Question 5

RENAL: Guidelines

F - aerobic, resistance
I - HRR (2), RPE, HRMax
T - aerobic, resistance reps

Answer 5

frequency
- aerobic: 3-5x/wk
- resistance: 2-3x/wk

intensity
- HRR: min (<40%), mod (40-60%)
- RPE: 11-16
- HRMax: <75%

time
- aerobic: 20-60 mins
- strengthening: 10-15 reps, 1-3 sets