The acute intradialytic aerobic exercise increased phosphorus serum concentration and decreased total antioxidant capacity, reversing hypoxemia resulting from hemodialysis. The intradialytic exercise did not change the blood acid-base balance and the removal of solutes.

Patients with chronic kidney disease show poorer functional and cardiorespiratory capacity than healthy individuals, and these impairments result in sedentarism. The aim of this study was to conduct a systematic review and meta-analysis of randomized clinical trials on the effects of different intradialytic exercise protocols on cardiopulmonary capacity in chronic kidney disease patients. The primary outcome was peak oxygen consumption (VO2peak) and the secondary outcomes were exercise duration and ventilation in the cardiopulmonary test. The quality of the evidence was evaluated using the GRADE guidelines. Seven studies with a total of 124 participants met the inclusion criteria. Compared to the non-exercise group, the exercise group improved in mean VO2peak (MD 4.06 [IC 0.81; 7.31]). In a separate analysis according to exercise modality, aerobic exercise plus strength training performed better than aerobic exercise alone (MD 5.28 [IC 3.90; 6.66]). In the exercise group, both exercise tolerance values (MD 3.10 [IC 1.70; 4.51]) and ventilation values in the cardiopulmonary test were better than those of the control group (MD 13.10 [IC 7.12; 19.09]). Thus, intradialytic exercise protocols can improve cardiopulmonary function, exercise tolerance and ventilatory efficiency in chronic kidney disease patients.

This study suggests the potential role of intradialytic exercise to prevent the decrease in peripheral frequency of NK cell subsets during HD therapy. Moreover, moderate intensity intradialytic exercise did not exacerbate the systemic inflammation or induce muscle damage during HD therapy.

Percepção dos idosos jovens e longevos gaúchos quanto aos espaços públicos em que vivemThe perception of the young and long-lived elderly 'Gauchos' (from the State of Rio Grande do Sul, Brazil) about the public spaces they live in

Background: Chronic kidney disease (CKD) is a factor that predisposes to gradual physical deconditioning from its early stages leading to cardiorespiratory fitness and musculoskeletal system impairment. We evaluated the effects of combined and periodized intradialytic exercise training on cardiopulmonary fitness and respiratory function in HD subjects. Methods: A randomized controlled trial with HD subjects was allocated into two groups: exercise group (EXG) and usual care group (UCG). EXG performed a 12-week combined and periodized intradialytic training. UCG maintained the HD routine. Results: Thirty-nine HD subjects were analyzed (EXG = 20; UCG = 19). The EXG in comparison with the UCG showed improvements in peak oxygen consumption (Δ3.1 [0.4-5.5] vs. À0.2[À2.0-1.5] ml/kg/min; p = 0.003), forced expiratory volume in the first second (Δ0.

No abstract

Introdução: A doença renal crônica (DRC) causa prejuízos na capacidade funcional dos pacientes, comprometendo a qualidade de vida (QV). Objetivo: Avaliar a QV de pacientes com DRC em hemodiálise e compará-la entre gênero, estado civil e situação ocupacional. Métodos: Estudo observacional e transversal com portadores de DRC. Utilizou-se o Kidney Disease Quality of Life Short Form (KDQOL-SF). Resultados: Foram avaliados 60 pacientes, 31 homens, idade média de 56,3±12,3 anos. As mulheres apresentaram pior função física (p=0,02), capacidade física (p=0,04), emocional (p=0,02) e escore total do KDQOL-SF (p=0,03). Indivíduos viúvos apresentaram pior vitalidade/fadiga (p=0,01) e função cognitiva (p=0,01). Indivíduos empregados apresentaram menor efeito da DRC na vida diária (p=0,01) e no escore total do KDQOL-SF (p=0,01). A idade correlacionou-se fraca e negativamente com a função física (r= -0,258; p=0,046) e função sexual (r= -0,323; p=0,012). Conclusão: Mulheres, indivíduos viúvos e mais velhos com DRC apresentam piores escores no questionário de QV.

Background: The arteriovenous fistula (AVF) is a commonly used vascular access for chronic kidney disease (CKD) patients; exercise interventions may boost its maturation and help in its maintenance. A systematic review and meta-analysis of clinical trials on the effects of upper limb exercise programs on the AVF was conducted. Methods: The primary outcomes were draining vein diameter (DVD) and draining vein blood flow rate (DVBFR), and secondary outcomes were handgrip strength (HGS) and brachial artery flow rate (BAFR). Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Four studies met the inclusion criteria. When compared to usual care groups, the experimental groups did not improve DVD (mean difference [MD] 0.23, confidence interval [CI] −0.20–0.65). There were significant differences in DVBFR (mL/min) according to the fixed-effect model (MD 141.13, CI 36.84–245.42). HGS (kg) was significantly different between groups (MD 2.95, CI 0.55–5.35), but BAFR (mL/min) was not (MD 91.65, CI −94.72–278.01). Conclusions: Although exercise programs did not improve DVD and BAFR, they increased muscle strength and DVBFR. Therefore, experimental exercise programs should be emphasized for AVF maturation and maintenance. Research Registry number: reviewregistry924.