Efeito da prática de exercício aeróbico durante hemodiálise na capacidade funcional, no estresse oxidativo e na eficácia da diálise em pacientes com doença renal crônica

Abstract

Chronic kidney disease (CKD) is considered worldwide as the "epidemic of the XXI century". The prevalence of CKD increases with age, so individuals with more than 60 years are more likely to develop it. Patients on hemodialysis (HD) are less active, have low exercise tolerance and high physical deconditioning. Some studies have shown the benefits of exercise programs for this population. We aim with this research was to evaluate the effects of aerobic exercise intradialytic functional capacity, oxidative stress and the dialysis efficacy in HD nephropathy. The 22 adult patients of both sexes with CKD were randomly allocated into two groups: an intervention group (IG) and control group (CG). The first part of a program of supervised aerobic exercise that took place from August to November 2013. Program lasted 12 weeks, was conducted in the first two hours of HD three times a week, employing a active electromagnetic cycle ergometer (minibike acte sports) for lower limbs, consisting of heating, air conditioning and cooling. The GC was instructed not to perform regular physical activity during the study. To assess the functional capacity of the patients were subjected to the six-minute walk test (6MWT), sit and reach the feet and the chair lift tests. Markers of oxidative stress (superoxide dismutase enzyme (SOD) and catalase (CAT) in leukocytes) were analyzed through blood samples for laboratory tests and the index of the dialysis efficacy (Kt/V Daugirdas) was collected from patients' medical records. Results for oxidative stress demonstrated for CAT average of 0.80 ± 0.26 at baseline and 1.05 ± 0.35 at the end (p = 0.972) and SOD average of 1.60 ± 0.78 and 2.83 ± 1.82, achieved statistical significance (p = 0.046). While the findings for functional capacity for the 6MWT showed an initial mean of 435.1 ± 117.9 m distance , there was a slight decrease, though not significant (p = 0.499) at the final assessment (425.6 ± 111,9 m) of the GI. To test the chair lift , a significant increase in the number of repetitions, which ranged from 9.9 ± 2.5 times the baseline to 12.1 ± 2.5-fold ( p = 0.026 ) at the end of the aerobic workout. In addition, the sit and reach test feet, took the value of 3.4 ± 8.1 cm to 6.4 ± 9.83 cm in the final evaluation. The results were statistically significant (p = 0.046)