Exercise training in peripheral vascular arterial disease in hemodialysis patients: a case report and a review.
BACKGROUND
Peripheral arterial disease (PAD) is frequently diagnosed in subjects with chronic kidney disease. Hemodialysis (HD) patients with PAD show increased morbidity and mortality and health care costs increase. Management of this complication requires time and skill by nephrologists, although negative results are frequent.


METHODS
A 59-year-old Caucasian man on HD with advanced lower extremities peripheral disease and massive calcification of a plaque in the abdominal aorta has been enrolled in a home-based exercise training program. His compliance was high and claudication improved. Pain threshold speed (PTS) and maximal walking speed rose from 2.8 and 3.3 to 3.6 and 4.6 Km/h respectively. The increasing functional capability improved his quality of life and changed positively his life-style.


CONCLUSIONS
Physical exercise confirms its effectiveness in reducing symptoms due to PAD. A rehabilitation program performed at home at a specific velocity, just below the PTS, and maintained by a metronome appears to be well suited for HD patients because it induces functional improvements and vascular adaptations with low costs.
Fabbian
Fabio
F
Renal Unit, St. Anna Hospital, Ferrara, Italy. f.fabbian@ospfe.it
Manfredini
Fabio
F
Malagoni
Anna Maria
AM
Malacarne
Franco
F
Russo
Giorgia
G
Soffritti
Silvia
S
Molino
Christian
C
Catizone
Luigi
L
D001011:Aorta / Q000473:pathology; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002908:Chronic Disease; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011788:Quality of Life; D011859:Radiography; D006435:Renal Dialysis