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Advisor(s)
Abstract(s)
The chronic kidney disease (CKD) is characterized by the loss of the kidney’s ability to eliminate toxic
substances, concentrate urine and conserve electrolytes, with subsequent alteration of the remaining kidney function.
The severe loss of kidney function is a first-order threat to life and requires the removal of toxic waste that cannot be
debugged with sufficient effectiveness for other organ systems, as well as the restoration of an adequate volume and
composition of body fluids - dialysis. If the loss of renal function is irreversible patients have two options: kidney
transplant or chronic dialysis. Since 1977, with the pioneering study by Jette et al., it is well documented that
patients with CKD on hemodialysis are limited in their overall physical capacity between 60 and 70% of that
expected for their age, compared with healthy patients [1] and most CKD patients are sedentary [2], [1]. With this
study, our main objective is to evaluate the functional status of hemodialysis patients with CKD.
León University, León, Spain
The study was carried out by the NorDial Clinic (Mirandela city – Portugal) in a total
population of 123 patients. We met the exclusion criteria defined by the American College of Sports Medicine.
Tests: anthropometric measurements, sit-to-stand, up and go, handgrip strength and blood tests. Material: Tefal scale
accurate to ± 100g, metric stadiometer (Detecto D52, USA), chair of 46cm, 8 memory stopwatch with precision
1/100 seconds (Bravo, Spain), cone with 40cm, manual hydraulic dynamometer Jamar®60.5% of the patients of our study were men. This data is extremely variable in publications on
hemodialysis. The average age of our participants is 63.46 years (women) and 61.16 years (men). But more
important than biological age is the time on hemodialysis, since we know that the mortality of these patients
increases in proportion to years of treatment. The men in our sample were on hemodialysis for 4.42 years and
women for 6.17. In the sit-to stand 60s test both men and women were able to reach an average of more than 30
repetitions (35.76±9.66 and 32.26±8.46 respectively). These values are higher when compared with other studies
[3]. It is widely reported that patients undergoing hemodialysis have marked skeletal muscle dysfunction and that
this dysfunction is also observed in handgrip strength. The values found in this study (175.91±51.35N for women
and 321.1±84.1 for men, both for right hand) agree with the findings in the scientific literature. Comparing men
and women, we observe lower values of strength in women as showed in other studies, which is perfectly described
by the metabolic and structural differences. This is an important result due to the relationship between handgrip
strength and quality of life [4]. The up-and-go test is a classic test to assess the mobility and walking capacity and is
strongly related to lower limb strength and balance. In our study the results of this test were 7.6±3.05s and
9.37±3.78, for men and women respectively – results slightly higher than others published in other investigations
like in [5]. As it is well known, the internal milieu of hemodialysis patients suffer numerous homeostatic changes
derived from many factors, making it difficult to interpret analytical results, comparing men and women. Anyway,
we found no baseline differences in the data published by other researchers relating to hemoglobin and hematocrit,
since there is a consensus on the minimum tolerable to keep these patients through the dosage of erythropoietin.
The anthropometrics results of our patients are similar to other publications.
b) The overall functional capacity of our patients is lower than healthy population.
c) The overall functional capacity of our patients is higher than shown by other studies.
Description
Keywords
Hemodialysis Functional evaluation Chronic kidney disease
Citation
Novo, André; Travassos, Francisco; Teixeira, Fernanda; Múrua, Aldo; Azevedo, José; Alves, Maria José; de Paz, José (2011). Functional evaluation of patients undergoing hemodialysis with chronic kidney disease. In 7th EFSMA – European Congress of Sports Medicine 3rd Central European Congress of Physical Medicine and Rehabilitation. Salzburg, Austria. p. 163-164
Publisher
Austrian Society of Physical Medicine and Rehabilitation