Functional evaluation training prescription for patient with chronic renal failure under hemodialysis: A case report
Abstract
The Chronic Renal Failure refers to a syndromic diagnosis of progressive and, generally irreversible, damage in the renal function of depuration, in other words, the filtration. Objectives: The purposes of this study are: evaluate the functional capacity of the patient with Chronic Renal Failure under dialysis and prescribe an aerobic training using blood lactate threshold. Materials and methods: One patient with Chronic Renal Failure was evaluated through anamnesis, 1200m walking test, bicycle ergometer test, measure of the blood lactate threshold by enzymatic method and the quality of life questionnaire SF-36. The patient was submitted to an aerobic training based in the blood lactate threshold, in 3 weekly sessions during 8 weeks. The initial outcomes were compared to that obtained after 8 weeks training. Outcomes: After the 8 weeks training, there was an increase of the hemoglobin concentration and hematocrit, the maximal oxygen uptake, the lactate threshold training load, decrease of the rest lactate concentration and improvement related to the pain evaluated by the quality of life questionnaire SF-36. Conclusion: The Chronic Renal Failure porter when submitted to a specific evaluation and having a multiprofessional carrying, can get a personalized physical training in order to minimize the effects of deconditioning and the pathologies associated to Chronic Renal Failure.
References
Alonso, J.; Prieto, L.; Antó, J..M. La versión Española del "SF-36 Health Survey" (Cuestionario de Salud SF-36): un instrumento para la medida de los resultados clínicos. Medicina Clinica,104(20):771-776, 1995.
Anderson, R. Skeletal muscle phosphorus and magnesium deficiency in alcoholic myopathy. Mineral Eletrolytc Metab, 4:106-112, 1980.
Barnea, N.; e colaboradores. Exercise tolerance in patients on chronic hemodialysis. Israel J Med Sci, I6(1):17-21, 1980.
Bergamaschi, C.; Boim, M.A. Rim e exercício físico. Rev Bras Nefrol, 13:33-7, 1991.
Brautbar, N. Skeletal myopathy in uremia: abnormal energy metabolism. Kidney Int.16:S81, 1983.
Broyer, M.; Delaporte, C.; Maziere, B. Wath electrolytes and protein content of muscle by nedle biopsy in uremic children. B Medicine, 38: 278-285, 1974.
Carney, R.M.; Mckevitt, P.M.; Goldberg, A.P. Psychological effects of exercise in hemodialysis patients. Nephrol, 33:179, 1983.
Carney, R.M. Recombinant erythropoietin improves exercise capacity in anemic hemodialysis patients. Am J Kidney Dis, 4:325-32, 1990.
Daugidas, J.T.; Blake, P.G.; Todd, S.L. Manual de diálise. Medsi. São Paulo, 2003.
Diesel, W.; Noakes, T.D.; Swanepoel, C.; e colaboradores. Isokinetic muscle strength predicts maximun tolerance in renal patients on chronic hemodialysis. Am J Kidney Dis, 16:109-14, 1990.
Eschbach, J.W.; e colaboradores. The anemia of chronic renal failure in sheep response to erithropoietin plasma in vivo. J Clin Invest, 74:434- 441, 1984.
Eschbach, J.W.; Adamson, J.W. Anemia of end-stage renal disease (ERDS). Kidney Int, 28:1-5, 1985.
Eschbach, J.W.; e colaboradores. Correction of the anemia of end stage renal disease recombinant human erythropoietin. N Engl J Med, 73-78, 1987.
Floyd, M. Myopathy in chronic renal failure. K J Med, 53:509, 1974.
Garrett, W.; Kirkendall, D. A ciência do exercício e dos esportes. Editora ArtMed, 1ª ed. cap.14, pg 242-250, 2003.
Goldberg, A.; e colaboradores. Therapeutic benefits of exercise training of hemodialysis patients. Cli Nephrol, 1982.
Goldberg, A.; Geltmam, E.; Gavin, J. Exercise training reduces coronary risk and effectively rehabilitates hemodialysis patients. Nephron, 42:311, 1986.
Goldstein, D.A.; Chui, L.A.; Massry, S.G. Effect of parathyroid hormone and uremia on peripheral nerve calcium and motor nerve conduction velocity. J Clin Invest, 22:88- 93, 1978.
Gollnick, P.; Saltin, B. Fuel for musclar exercise: role of fat in exercise, nutrition, and energy metabolism. Ed. MacMillian. pg, 72 – 88, 1988.
Gómes-Fernández, P. Effect of parathyroidectomy on respiratory muscle strength in uremic myopathy. Am J Nephrol, 7:466-469, 1987.
Gupta, A.; Goswami, A.K.; Sadhuklian, O.N.M. Comparative study of lactate removal in short term massage of extremities, active recovery and a passive recovery period after supramaximal exercise sessions. Int J Sports Med, v. 17, n. 2, p.106-110, 1996.
Heck, H.; Mader, A. Justification of the 4-mMol lactate threshold. International Journal of Sports Medicine, 6:117-30, 1985.
Heimberg, K.W. Active calcium transport of sarcoplasmic reticulum during experimental uremia: changes in kinetics and lipid composition. Eur J Biochem, 61:207-213, 1976.
Herrera, J.B. Estudo comparativo do limiar anaeróbio antes e depois de um programa de treinamento em sedentários de 40 a 50 anos de idade. Ver Brás Ciên e Mov, 9(3):53-56, 2001.
Horl, W.H.; Sperling, J.; Heidland, A. Enhance glycogen turnover in skeletal muscle of uremic rats: cause of uncontrolled actomyosin ATP. A J Clin Nutr, 31:1861-1864, 1978.
Hricik, L.E.; Sedor, J.R.; Ganz, M.B. Segredos em Nefrologia. Artmed. Porto Alegre, 2002.
Kempeneers, G.; Noakes, T.D.; Van Zyl-Smith, R.; e colaboradores. Skeletal muscle limits the exercise tolerance of renal transplant recipients: effects of a graded exercise training program. Am J Kidney Dis, 16:57-65, 1990.
Kevin, K.; Mccully, S.S.; Sheeva, R.; John, S.; Leigh, J.R.; Natelson, B.H. Muscle metabolism with blood flow restriction in chronic fatigue syndrome. J Appl Physiol, 96: 871-878, 2004.
Kouidi, E. The effects of exercise training on muscle atrophy in hemodialysis patients. Nephro Dial Transplant. 13:685-689, 1988.
Lazarus, M.J.; e colaboradores. Hemodinamic study. Kidney M, 21:868-876, 1982.
Lazarus, M.J.; Hakinn, R.M. Medical aspects of hemodiaysis. The Kidney. Fourth Edition.W.B. Saunders Company, 2:2223-2298, 1991.
Mader, A.; Heck, H. A theory of the metabolic origin of the anaerobic threshold. International Journal of Sports Medicine, 7: 45 – 65, 1986.
Mallette, L.E.; Patten, B.M.; Engel, K. Neuromuscular disease in secondary hyperparathyroidism. Ann Intern Med, 82:474-483, 1975.
Mandal, A.K.; Jennette, J.C. Doença Renal e hipertensão: diagnóstico e tratamento. Revinter. Rio de Janeiro, 1993.
Martins, M.R.I.; Cesarino, C.B. Atualização sobre programas de educação e reabilitação para pacientes renais crônicos submetidos à hemodiálise. J Brás Nefrol 26(1):45-50, 2004.
Massry, S.G. The toxic effects of parathyroid hormone in uremia. Semin Nephrol, 3:306- 328, 1983.
Mayer, G.T.; Gránt, H. Anemia end reduced exercise capacity in patients on chronic hemodialysis. Clin Sci, 76: 265-268, 1989.
Medeiros, R.H.; Pinent, C.E.; Meyer, F. Physical fitness of chronic renal disease subjects. J Bras Nefrol, 24(2):81-7, 2002.
Miller, T.D.; Squires, R.W.; Gau, G.T.; e colaboradores. Graded exercise testing and training after renal transplantation: a preliminary study. Mayo Clin Proc 6:773-77, 1987.
Moreira, P.R.; Barros, E. Atualização em fisiologia e fisiopatologia renal: bases fisiopatológicas da miopatia na insuficiência renal crônica. J Bras Nefrol, 22(1): 201-208, 2000.
Moreira, P.R.; Barros, E.G. Revisão/ atualização em diálise: capacidade e condicionamento físico em pacientes mantidos em hemodiálise. J Bras Nefrol, 20(2) 207- 210, 1998.
Natale, V.M.; Brenner, I.K.; Moldoveanu, A.I.; Vasiliou, P.; Shek, P.; Shephard, R.J. Effects of three different types of exercise on blood leukocyte count during and following exercise. Rev Paul Med, 121(1):9-14, 2003.
Nehlsen-Cannarella, S.L.; Nieman, D.C.; Balj-Lamberton, A.J.; e colaboradores. The effects of moderate exercise training on immune response. Med Sci Sports Exerc, 23(1):64-70, 1991.
Nieman, D.C.; Nehlsen-Cannarella, S.L.; Donohue, K.M.; e colaboradores. The effects of acute moderate exercise on leukocyte and lymphocyte subpopulations. Med Sci Sports Exerc, 23(5):578-85, 1991.
Oh-Park, M; e colaboradores. Exercise for the dialyzed: aerobic and strength training during hemodialysis. Am J Physical Medicine and Rehabilitation, 81(11):814-21, 2002.
Painter, P.; Zimmerman, S. Exercise in end-stage renal disease. Am J Kidney Dis. 1986.
PAINTER, P. Exercise and End-stage Renal Disease. Exerc Sport Sci Rev, 16:305-339, 1988.
Painter, P. The importance of exercise training in rehabilitation of patients with end stage renal disease. Am J Kidney Dis, 24(1):52-59, 1994.
Parmley, W. Recommendations of the American College of Cardiology on cardiovascular rehabilitation. Cardiology, 4, 1986.
Powers, S.K.; Howley, E.T. Exercise physiology: theory and application to fitness and performance. Ed. McGraw-Hill, 1997.
Publicover, S.J.; Duncan, C.J.; Smith, J.L. The use of A23187 to Demonstrate the Role of intracellular calcium in causing ultrastructural damage in mammalian muscle. J Neuropath Exp Neurol, 37:544-557, 1978.
Riella, M.C. Princípios de nefrologia e distúrbios hidroeletrolíticos. Guanabara Koogan. 4ª edição, p 649-690, Rio de Janeiro, 2003.
Rodman, J.S.; Barker, T. Changes in the kinesis of Muscle Contraction in Vitamin-D depleted. Rev Kidney lnt, 13:189-193, 1978.
Rodrigues-Machado, M.G.; Castro, A.M.; Coelho, D.M. Respiratory function evaluation and reabilitation of patients with chronic renal insuficiency under hemodialysis. European Resp Journal, v: 16, supl 31, p. 505, 2000.
Sam, M.; Swanepoel, C.; Noakes, T. Effects of exercises training and recombinant human erithropoetin in patients receiving chronic hemodialysis. Med Sci Sports Exerc, 1994.
Savica, V. Plasma and muscle carnitine levels in hemodialysis patients with morphological ultrastructural examination of muscle samples. Nephron, 35:232-236, 1983.
Scanlan, C.L.; Wilkins, R.L.; Stoller, J.K. Fundamentos da terapia respiratória de Egan. Manole. 7ª edição. São Paulo, 2000.
Tanaka, K. Relationships of anaerobic threshold and onset of blood lactate accumulation with endurance performance. European Journal of Applied Physiology, 52:51-56, 1983.
Wasserman, K. Anaerobic threshold and respiratory gas exchange during exercise. Journal of Applied Physiology, 35: 236-43, 1973.
Weltman, A. e colaboradores. Reliability and validity of a continuous incremental treadmill protocol for the determination of lactate threshold, fixed blood lactate concentration, and VO2máx. Internacional Journal of Sports Medicine, 11:26-32, 1990.
Zabetakis, P.M.; Gleim, G.W.; Pasternak, F.L.; Saraniti, A.; Nicholas, J.A.; Michelis, M.F. Long-duration submaximal exercise conditioning in hemodialysis patients. Clin Nephro, 18:17-22, 1982.
Zhang, Y. Effect of exercise testing protocol on parameters of aerobic function. Medicine and Science in Sports and Exercise, 23: 625 – 30, 1991.
Authors who publish in this journal agree to the following terms:
- Authors retain the copyright and grant the journal the right of first publication, with work simultaneously licensed under the Creative Commons Attribution License BY-NC which allows the sharing of the work with acknowledgment of the authorship of the work and initial publication in this journal.
- Authors are authorized to enter into additional contracts separately for non-exclusive distribution of the version of the work published in this journal (eg, publishing in institutional repository or book chapter), with acknowledgment of authorship and initial publication in this journal.
- Authors are allowed and encouraged to post and distribute their work online (eg, in institutional repositories or on their personal page) at any point before or during the editorial process, as this can bring about productive change as well as increase impact and impact. citation of published work (See The Effect of Free Access).
