Outpatient Cardiac Rehabilitation Suppresses Deterioration of Renal Function in Patients ≥75 Years of Age With Heart Disease

• Published in: Circulation Journal Vol. 85; no. 5; pp. 612 - 622
• Main Authors: Sasamoto, Yuichiro, Endo, Noriko, Kanazawa, Kohko, Utsumi, Taeko, Takahashi, Tomomi, Endo, Yosuke, Nanba, Makoto, Takeda, Hiroto, Takano, Tomohiro, Takahashi, Koki, Tanji, Masahiro, Kohzuki, Masahiro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 23.04.2021
• Subjects: Aged; Cardiac Rehabilitation; Creatinine; Cystatin C; Glomerular Filtration Rate; Heart Diseases; Humans; Kidney - physiology; Kidney disease; Outpatients; Patient readmission; Physical activity; Prospective Studies; Kidney disease; Physical activity; Patient readmission; Cystatin C; Glomerular filtration rate
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-20-0970

Background:This study investigated the effect of outpatient cardiac rehabilitation (OCR) and physical activity on the estimated glomerular filtration rate based on serum cystatin C (eGFRcys) in patients with heart disease (HD) aged ≥75 years.Methods and Results:This non-randomized prospective intervention study involved 136 patients (non-OCR group, n=66; OCR group, n=70), 55 of whom were aged ≥75 years (non-OCR group, n=29; OCR group, n=26). Renal function (eGFRcys) was evaluated at discharge and 3 months thereafter. A linear mixed model (LMM) was used to assess changes in renal function over time. The hospital readmission rate within 3 months after discharge was also evaluated. LMM analysis showed that the change in eGFRcys was −2.27 and +0.48 mL/min/1.73 m2in the non-OCR and OCR groups, respectively (F=2.960, P=0.022). Further, among patients aged ≥75 years in the non-OCR and OCR groups, the change in eGFRcys was −3.83 and −1.08 mL/min/1.73 m2, respectively (F=2.719, P=0.039). The proportion of patients aged ≥75 years who were rehospitalized due to exacerbation of HD was 16.9% (n=10) and 6.7% (n=2) in the non-OCR and OCR groups, respectively.Conclusions:Among patients with HD aged ≥75 years, participation in OCR reduces the decline in renal function and hospital readmission rates.