Effects of exercise training on aerobic and functional capacity of end‐stage renal disease patients

Abstract

The aim was to assess the effects of exercise training on aerobic and fuctional capacity of patients with end-stage renal disease (ESRD). Patients completed an incremental exercise test on a cycle ergometer to determine VO2 peak and VO2 at ventilatory threshold (VT; V-slope). On a separate day they performed two constant load exercise tests on a cycle ergometer at 90% of VT and at a workload of 33 W, to determine VO2 kinetics. Functional capacity was assessed using measurements of sit-to-stands (STS-5, STS-60) and a walk test. Dialysis patients were randomly allocated to an exercise (ET: n = 18, age = 57.3 years) or control (C: n = 15, age = 50.5 - 5 years) group. The ET group participated in an exercise training programme involving cycling for 3 months. Repeated measures ANOVA revealed significant time by group interactions (P < 0.05) following training for VO2 peak (ET: 17 +/- 6.1 versus 19.9 +/- 6-3, C: 19.5 +/- 4.7 versus 188 +/- 4.9 ml kg min(-1)) and VO2-VT (ET: 10.7 +/- 3.5 versus 11.8 +/- 3.3, C:12.9 +/- 3.2 versus 119 +/- 3.5 ml kg min(-10). VO2 kinetics remained unchanged in both groups at 90% -VT, but a trend (P = 0.059) towards faster kinetics at the 33 W was observed (ET: 49.6 +/- 19.5 versus 37.8 +/- 12.7, C: 42.8 +/- 13 versus 49.4 +/- 20.2 s). Significant time by group interactions (P < 0.05) were also observed for STS-5 (ET: 14.7 +/- 6.2 versus 11.0 +/- 3.3, C: 12.8 +/- 4.4 versus 12.7 +/- 4.8 s) and STS-60 measurements (ET: 21.2 + 7.2 versus 26.9 +/- 6.2, C: 23.7 +/- 6.8 versus 24.1 +/- 7.2). Three months of exercise rehabilitation significantly improves peak exercise capacity of patients with ESRD. Measurements of VO2 kinetics and functional capacity suggest that longer time might be needed to induce peripheral adaptations.

Treinamento aeróbico melhora a capacidade funcional de pacientes em hemodiálise crônica

“…These findings contrast with some publications reporting an average increase of 20% in the VO 2PEAK in chronic renal patients undergoing AE [24][25][26] , which is also opposite to the findings obtained in the 6MWT. These discrepancies may be related to technical difficulties for examination, such as age, comorbidities, difficult to understand.…”

Exercise in the End-Stage Renal Disease Population

“…On average, aerobic exercise training for 8 wk to 6 mo improves VO 2peak by approximately 17% (Figure 3), but there is considerable variability from study to study, and many studies have been uncontrolled (16,18,30,(32)(33)(34)(35)(36)41,43). Only two of these studies included patients who were on peritoneal dialysis (35,40). Many studies were conducted before the routine use of erythropoietin to control the anemia that is associated with chronic kidney disease (CKD), but the effects of aerobic training seem to be similar among patients who receive erythropoietin ( Figure 3).…”

Physical exercise modifies the functional capacity of elderly patients on hemodialysis

“…There was a signi icant increase in the covered distance at 6MW (Z = 2.52; p < .012), number of STS repetitions (Z = 2.54; p < .001) and respiratory muscle strength (MIP: Z = 2.53; p < .011; MEP : Z = 2.54; p < .011), as shown in Figure 2. (29) (mean age of 55.6 years), which compared isolated effects of resistance training and Koufaki, Mercer & Naish's study (30) (mean age of 53.9 years), which compared the isolated effects of aerobic training, also found an increase in the repetition number or, a reduction in execution time in STS. Such improvement may be attributed to the fact that physical exercise improves the muscular structure, the number of capillaries and mitochondria, which are responsible for getting oxygen (31), and the capacity of performing physical exercise (6).…”