Clinical and experimental nephrology · 2026
Epidemiology of rehabilitation practices for inpatients with nephrotic syndrome: a retrospective cohort study using an administrative database.
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Shinkawa Kanna, Yoshida Satomi, Nakao Yoko M, Hayashi Ayano, Sakoda Kazunori, Yanagita Motoko, Kawakami Koji
Аннотация
INTRODUCTION: The clinical characteristics of patients with nephrotic syndrome undergoing in-hospital rehabilitation are not well-understood, and the effects of exercise on acute kidney injury (AKI) or venous thromboembolism (VTE) in this population remain unclear.
METHODS: We conducted a retrospective cohort study using a nationwide Japanese administrative claims database. We examined the clinical background of patients aged ≥ 18 years with nephrotic syndrome who underwent in-hospital rehabilitation. In a subgroup analysis of patients with nephrotic syndrome hospitalized for 14-90 days, we assessed the associations between rehabilitation intensity or early initiation and the development of AKI and VTE, as well as changes in activities of daily living (ADL), using multivariate logistic regression. Several sensitivity analyses were performed to confirm the robustness of the results.
RESULTS: Among the 6989 patients with nephrotic syndrome who were hospitalized for ≥ 7 days, 1447 (20.7%) received rehabilitation. Factors associated with rehabilitation included older age, female sex, AKI, cerebrovascular disease, use of intravenous corticosteroids, anticoagulants, diuretics, hypoglycemic drugs, and longer hospital stay. In the subgroup analysis, no statistically significant association was detected between rehabilitation intensity or early initiation and the development of VTE, AKI, or improvements in ADL during hospitalization.
CONCLUSIONS: We described the clinical characteristics of patients with nephrotic syndrome who received in-hospital rehabilitation. In patients with nephrotic syndrome, no statistically significant association was detected between rehabilitation intensity or early initiation and the risk of VTE or AKI. Further studies are warranted to evaluate the effectiveness and safety of rehabilitation in patients with nephrotic syndrome.
METHODS: We conducted a retrospective cohort study using a nationwide Japanese administrative claims database. We examined the clinical background of patients aged ≥ 18 years with nephrotic syndrome who underwent in-hospital rehabilitation. In a subgroup analysis of patients with nephrotic syndrome hospitalized for 14-90 days, we assessed the associations between rehabilitation intensity or early initiation and the development of AKI and VTE, as well as changes in activities of daily living (ADL), using multivariate logistic regression. Several sensitivity analyses were performed to confirm the robustness of the results.
RESULTS: Among the 6989 patients with nephrotic syndrome who were hospitalized for ≥ 7 days, 1447 (20.7%) received rehabilitation. Factors associated with rehabilitation included older age, female sex, AKI, cerebrovascular disease, use of intravenous corticosteroids, anticoagulants, diuretics, hypoglycemic drugs, and longer hospital stay. In the subgroup analysis, no statistically significant association was detected between rehabilitation intensity or early initiation and the development of VTE, AKI, or improvements in ADL during hospitalization.
CONCLUSIONS: We described the clinical characteristics of patients with nephrotic syndrome who received in-hospital rehabilitation. In patients with nephrotic syndrome, no statistically significant association was detected between rehabilitation intensity or early initiation and the risk of VTE or AKI. Further studies are warranted to evaluate the effectiveness and safety of rehabilitation in patients with nephrotic syndrome.