A Nontraditional Approach to Cardiac Rehabilitation in the Dialysis Center for a Patient with End-stage Renal Disease Following Coronary Artery Bypass Surgery: A Case Report.

Background And Purpose: Cardiac rehabilitation (CR) promotes positive outcomes following coronary artery bypass grafting (CABG) surgery. Patients with end-stage renal disease (ESRD), who have an increased risk of cardiac mortality and mobility, have also experienced positive outcomes following CABG. However, participation in CR continues to be limited due to lack of physician referrals, patient compliance, accessibility, and time. Can a CR program be implemented safely and effectively following CABG in a patient during dialysis sessions?

Case Description: The patient was a 43-year-old male with a history of: ESRD requiring hemodialysis (HD), CABG, hypertension (HTN), and hyperlipidemia. During HD treatments, the patient received CR that included aerobic exercise and education for 16 weeks (26 visits) under the supervision of a physical therapist.

Outcomes: The patient gained improvements in: 2-minute walk distance, quality of life (QOL), based on the Short Form-36 (SF-36), and a reduction in modifiable cardiac risk factors. No adverse events occurred during the intervention.

Discussion: A 16-week CR program was implemented safely and effectively following CABG in a patient undergoing concurrent dialysis. This patient demonstrated improved outcomes comparable to patients who receive traditional cardiac rehabilitation following CABG.