Respiratory muscle strength and quality of life in chronic kidney disease patients undergoing hemodialysis

Abstract

Introduction: Hemodialysis (HD) sessions associated with the chronic kidney disease (CKD) repercussions may cause respiratory muscle impairment and limitations of daily living activities, which may compromise the quality of life. Objective: To evaluate respiratory muscle strength and quality of life in HD patients. Methods: A cross-sectional study involving CKD patients of both sexes undergoing HD. All were evaluated during HD, using an evaluation form containing personal and clinical data, presence of comorbidities, lifestyle (including self-reported physical activity) and vital signs. Respiratory muscle strength was analyzed by maximum inspiratory (MIP) and maximum expiratory (MEP) pressures by manovacuometer and quality of life using the SF-36 questionnaire. Results: Sixty-eight patients were evaluated (69.1% men), with a mean age of 54.9 ± 13.6 years. The MEP% was below of predicted (79.5 ± 25.7) and the MIP% was reduced only in women (77.8 ± 38.7). The MIP% was related to CKD time (p = 0.04) in men. The SF-36 domain that showed the most impairment was physical limitation [25.0 (13.0-67.0)], while mental health was the least impaired domain [72.0 (62.0-84.0)]. Those who reported the practice of physical activity obtained better results in vitality domain (p = 0.01). In the analysis stratified by sex, the functional capacity domain was less compromised in men who practiced self-reported physical activity (p = 0.02). Conclusion: CKD patients undergoing HD had a reduction in MEP relative to predicted, in addition to a greater impairment of MIP in men with longer CKD time and in women alone, although the clinical relevance of this finding is uncertain. Quality of life was more compromised in the physical limitation domain, where those who self-reported physical activity achieved better results in the domains of vitality (total sample) and functional capacity (men).

Benefits of Intradialytic Physiotherapy in Chronic Kidney Patients: An Integrative Review

“…Physiotherapy has preventive skills, improvements and delay of complications from kidney disease. Abdo et al (2019) demonstrate that a physiotherapeutic intervention protocol in patients with RD during HD can still be effective in increasing quadriceps muscle strength, handgrip strength, which is directly related to lung capacity and expiratory muscle strength SILVA et al, 2021;SIMÕES et al, 2020).…”

“…As for the benefits of the respiratory system, intradialytic physiotherapy when performed with a more specific therapeutic proposal for this aspect, such as Inspiratory Musculature Training (IMT), results in positive effects on exercise tolerance, increase in maximum inspiratory pressure and lung capacity, which have a positive impact on other physical and functional aspects, as suggested by studies by Dipp et al (2020), Hargrove et al (2021) and Silva et al (2021).…”