Influência do treinamento aeróbico, realizado durante as sessões de hemodiálise, sobre a capacidade funcional e a pressão arterial de portadores de doença renal crônica

Abstract

In general population, physical fitness has been shown to improve functional capacity and to reduce cardiovascular events. On the other hand, in patients with chronic kidney disease, which have significant reduction of functional capacity, high prevalence of hypertension and high rates of cardiovascular mortality, there are only a few studies evaluating the effects of exercise training on functional capacity and on blood pressure control. Therefore, the objective this study was to evaluate the effect of aerobic training performed during hemodialysis sessions on functional capacity and hypertension control of patients with chronic kidney disease. Fourteen patients with chronic kidney disease on hemodialysis treatment were evaluated before and after 12 weeks of aerobic training cycle held in the lower limbs during the hemodialysis sessions. Patients underwent 24 hours ambulatory blood pressure monitoring, six-minute walking test and exercise cardiopulmonary test before and after the period of 12 weeks of training (p < 0,05). It was found that among the patients, four males and 10 females, mean age 47,6 ± 12,79 years, five were white and nine were black and the time of hemodialysis ranged from 93,7 ± 43,90 months. The patients underwent ambulatory blood pressure monitoring, 24 hours, the test for 6 minutes of walking and exercise cardiopulmonary test both before and after the period of training (p < 0.05). After the period of aerobic training, there is increasing distance in the test of the 6 minute walk 509 m to 555 ± 91.9 ± 105.8 m (p < 0, 001), and reduction of systolic blood pressure of 151 ± 18.4 mm Hg to 143 ± 14,7 mm Hg (p = 0,08), diastolic blood pressure of 94 ± 10,5 mm Hg to 91 ± 9,6 mm Hg (p = 0,05), pressure mean blood of 114 ± 13.0 mm Hg to 109 ± 11.4 mm Hg (p = 0,07), systolic blood pressure in the sleep of 150 ± 23,9 mm Hg to 140 ± 19,3 mm Hg (p = 0,02), diastolic blood pressure in the sleep of 93 ± 15,3 mm Ng to 88 ± 14,3 mm Ng (p = 0,01), mean arterial pressure during sleep was 112 ± 18.0 mm Hg to 106 ± 16.1 mm Hg (p = 0,04). The value of peak oxygen consumption in the first and second ventilatory threshold increased from 20,6 ± 6,92 mL/kg.m-1 to 21,2 ± 10,13 mL/kg.m-1 (p = 0,45) in pre-and post-aerobic training. Laboratory variables in the hemoglobin increased from 10,8 ± 1.20 g/dL to 11,6 ± 11,6 g/dL (p = 0,04), the hematocrit increased from 32,8 ± 3,57% to 35,2 ± 2,76 (p = 0,03) and triglycerides increased from 96,6 ± 35,17 mg/dL to 127,0 ± 54,56 (p = 0,04) in pre-and post-aerobic training. Based on the results we can conclude that aerobic training performed during hemodialysis sessions improved functional capacity and contributed to hypertension control of patients with chronic kidney disease.