Functional training- effects on blood parameters in hemodialyzed patients
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abstract
Chronic kidney disease (CKD) is characterized by a progressive and irreversible decline in kidney function and that affects all other organs and systems. Patients with CKD on hemodialysis have reduced functional capacity and sedentary behavior, which results in increased morbidity and mortality. Over the past few years programs have been developed and implemented to maximize functionality with demonstrated beneficial effects in this specific population. Changes in the blood profile, resulting from these intervention programs, are not yet sufficiently studied. The objective of this study is to analyze the changes in the blood profile of the hemodialyzed patients after the implementation of a training program to maximize functionality. To achieve this objective a causal comparative research at a hemodialysis clinic was started. 24 individuals (intervention group) were included in a program of aerobic training (exercise bike and treadmill) before hemodialysis and 27 maintained their usual routine (control group). Anthropometric measurements (weight, height, body mass index) and functional capacity (sit-to-stand test, up and go test and handgrip strength test) were taken before and after the exercise program; the blood profile was monitored (leukocytes, neutrophils, hemoglobin and hematocrit, urea, creatinine, albumin, sodium, potassium, calcium, phosphorus, iron, iron-binding capacity, ferritin, glucose and parathormone) monthly throughout one year. The duration of hemodialysis, the administered dosage of darbepoetin and the adequacy ratio of hemodialysis treatment were assessed. The exercise program proved to be decisive on improving the functional capacity of these patients which translates into clear gains in autonomy to performing activities of daily living. In the intervention group the darbepoetin administration dosage has decreased, keeping the anemia parameters unchanged, which is an advantage for patients and reduces treatment costs. For other analytical parameters studied, it was not possible to establish effective relationship with the implementation of the exercise program. However, this variability was observed in both groups, which seems to indicate that the program had no adverse effects on these parameters and particularly in the dialysis efficacy. Hemodialyzed patients will benefit of rehabilitation care, with programs to maximize functionality, in daily treatment, therefore rehabilitation professionals must take part on multidisciplinary teams in hemodialysis clinics.
