Effect of Light-Intensity Physical Activity in An Older-Adult Patient With Minimal Change Nephrotic Syndrome and Acute Kidney Injury: A Case Report

Older adult patients with acute-onset minimal change nephrotic syndrome (MCNS) often have difficulties with exercise therapy due to uremia caused by severe generalized edema and acute kidney injury (AKI). Rehabilitation treatment targeting increased light-intensity physical activity (LPA) is typically implemented to address this limitation. An 81-year-old man with suspected MCNS complicated by stage I AKI was admitted to our hospital. The patient’s short physical performance battery (SPPB) score was 10 points, while his total physical activity (TPA) was 411 steps per day. To increase his LPA, the patient performed resistance exercises in the sitting position and standing activities with support under supervision five times per week at low load and high frequency. Physical activity education with self-monitoring using an activity meter and check sheet was also implemented during the unmonitored periods. After uremia and other symptoms improved, aerobic and resistance exercises were added. At discharge, the patient’s moderate-vigorous physical activity (MVPA) increased from 0.1 to 3.2 minutes per day; his LPA increased from 5.1 to 34.6 minutes per day; and his TPA increased from 411 to 3,233 steps per day. His SPPB score improved from 10 to 12 points, while the motor component of the functional independence measure (FIM) increased from 66 to 82 points, leading to improved activities of daily living (ADL). These results indicate that LPA-focused rehabilitation treatment in older patients with MCNS and AKI is both effective and feasible, potentially contributing to improved physical activity and ADL and facilitating the transition to exercise therapy after clinical improvement.