Is the peripheral muscle weakness a limitation to exercise on chronic kidney disease?

Abstract

Introduction: Chronic kidney disease (CKD) is a global public health problem with systemic repercussions, compromising muscle function and making patients less exercise tolerant. Objective: To verify the contribution of peripheral muscle strength in the exercise capacity of patients in hemodialysis (HD), as well as to compare peripheral muscle strength and exercise capacity between renal patients and healthy individuals. Method: 50 patients with chronic kidney disease (CKD) who performed HD and 13 healthy subjects underwent anthropometric evaluation, evaluation of peripheral muscle strength, pulmonary function test and exercise capacity assessment. Results: Simple linear regression indicated that the peripheral muscle strength contributed 41.4% to the distance walked in the six-minute walk test (R2 0.414; p < 0.001), showing that for every 1 Kgf reduced in the right lower limb the patient it stops walking 0.5m while for every 1 Kgf reduced in the lower left limb the patient stops walking 0.8m. In addition, it was observed that patients with CKD had a reduction in right lower limb muscle strength (129.44 ± 48.05 vs. 169.36 ± 44.30, p = 0.002), left (136.12 ± 52, 08 vs 168.40 ± 43.35, p = 0.01) and exercise capacity (421.20 ± 98.07 vs. 611.28 ± 80.91, p < 0.001) when compared to healthy pairs. Conclusion: Peripheral muscle weakness is an important limiting factor for exercise in CKD and patients on HD experience a decline in peripheral muscle strength and exercise capacity when compared to healthy individuals.

Efeitos Do Exercício Físico Na Qualidade De Vida E Aptidão Física De Pacientes Em Hemodiálise

“…Pacientes em HD têm sua força reduzida, o que causa a diminuição da força periférica e limita a capacidade de realização de exercícios físicos, quando comparados com indivíduos saudáveis. 25 Após as sessões de HD essa redução é ainda mais significante; ao aplicar o teste de dinamometria para verificação da Força de Preensão Manual (FPM) em 156 pacientes de uma clínica em São Paulo, verificou-se uma redução na FPM de 28,6 ± 11,4 kg para 27,7 ± 11,7 kg (p < 0,01). 26 Esse fato acontece devido à perda de fluidos, além de uremia, anemia, inflamação, processos metabólicos, distúrbios hormonais e nutricionais, bem como alterações na utilização do oxigênio nos tecidos musculares, levando à diminuição da FPM.…”