Efeitos nutricionais e imunológicos de um programa de exercício aeróbio intradialítico em portadores de doença renal crônica: ensaio clínico randomizado

Abstract

Chronic kidney disease (CKD) is a disease that can lead to progressive renal dysfunction and ultimately to severe renal failure and need for hemodialysis. Such patients present a high risk of malnutrition and chronic inflammation leading to an increase in cardiovascular mortality. In this study we evaluated changes in the nutritional profile (albumin, transferrin, leptin), inflammatory (cortisol, IL-10, CRP) and functional (6-minute walk test (T6) and hand-grip maneuver) after 12 weeks of physical exercise (EF). EF was performed by cycloergometer during hemodialysis (HD) in eight of 18 patients with CKD. There was a statistically significant reduction in cortisol (25.74 μg / dL ± 7.79 μg / dL at 14.17 μg / dL ± 4.06 μg / dL), statistically significant increase in transferrin (1.35 g / L ± 0.34 g / L at 1.55 g / L ± 0.31 g / L) and improvement in the six-minute walk test after 12 weeks of EF (374.82 m ± 139.04 m to 475.98 m ± 89.08 m). There was no change in serum levels of albumin, leptin, IL-10, CRP. There was also no increase in manual force measured through the hand-grip maneuver. Twelve weeks of intradialytic aerobic EF through cycloergometer was sufficient to reduce cortisol levels and elevate levels of transferrin and distance traveled at T6 in patients with CKD in HD.