著者

平野 裕真 河野 健一 山内 克哉 安田 日出夫

出版者

The University of Occupational and Environmental Health, Japan

雑誌

Journal of UOEH (ISSN:0387821X)

巻号頁・発行日

vol.44, no.3, pp.257-262, 2022-09-01 (Released:2022-09-09)

参考文献数

18

被引用文献数

1

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Patients with minimal change nephrotic syndrome (MCNS) are prone to loss of motor skills due to urinary protein leakage, steroid myopathy, and other factors. Acute kidney injury (AKI) is a common complication that contributes to the loss of physical function. Rehabilitation is crucial, but its efficacy and safety are unknown. Here we present a case of a patient with MCNS complicated by AKI, who commenced rehabilitation after dialysis was discontinued and experienced improved mobility. The patient, a woman in her 70s, was admitted to our hospital with bilateral lower limb edema and decreased urine output for approximately 5 days. Treatment with prednisolone and furosemide was initiated, but then dialysis was initiated due to AKI. Rehabilitation was started after dialysis was discontinued. The patient’s muscle strength and physical activity improved, and her exercise capacity and exercise tolerance improved without adverse effects. Rehabilitation may contribute to the improvement of exercise capacity without worsening renal function and urinary protein in patients with MCNS complicated by AKI.

著者

安田 日出夫

出版者

一般社団法人 日本透析医学会

雑誌

日本透析医学会雑誌 (ISSN:13403451)

巻号頁・発行日

vol.51, no.2, pp.129-133, 2018 (Released:2018-02-28)

参考文献数

19

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AKIの次世代バイオマーカーのうち, L-FABPとNGALが本邦で保険収載されているが, 臨床現場での利用が限られているのが現状である. AKI治療ガイドとしてのバイオマーカーが確立していないことが最も大きな要因と思われる. 近年, AKIに対する腎代替療法 (RRT) の適切なタイミングでの開始が生命予後を改善することが示されており, RRT導入予測バイオマーカーが確立できれば, 臨床応用が進む可能性がある. 本稿では, 次世代バイオマーカーの概略を解説し, 治療ガイドとしてのバイオマーカーの可能性を検討する.