Capacidade pulmonar, muscular e funcional de pacientes com doença renal crônica

Authors

  • Mariana Nunes Lúcio UDESC
  • Ana Karla Vieira Brüggemann UDESC
  • Davi de Souza Francisco UDESC
  • Stefani dos Santos Marcelino UDESC
  • Ana Flávia Gesser UDESC
  • Catherine Corrêa Peruzzolo UDESC
  • Elaine Paulin UDESC

DOI:

https://doi.org/10.33233/fb.v20i5.2609

Abstract

Objetivo: Conhecer o perfil pulmonar, muscular e funcional de pacientes com doença renal crônica (DRC) e verificar a relação entre a força muscular periférica e a capacidade funcional desses pacientes. Métodos: 21 pacientes com DRC e 17 saudáveis foram avaliados quanto í  antropometria, função pulmonar, força muscular periférica e capacidade funcional. Para comparação entres os grupos foi utilizado o teste t de Student ou U de Mann Whitney. Para correlacionar a força muscular periférica com a capacidade funcional do grupo DRC utilizou-se o coeficiente de Pearson ou Spearman. Resultados: Houve diferença estatisticamente significativa entre os grupos DRC e saudável, respectivamente, nas variáveis da função pulmonar: volume expiratório forçado no primeiro segundo (77,62 ± 18,05% vs. 99,71 ± 16,43%; p = 0,001) e capacidade vital forçada (78,86 ± 17,16% vs. 98,48 ± 16,99%; p = 0,001); e na força muscular periférica de quadrí­ceps direito (127,76 ± 49,77 Nm vs. 170,90 ± 55,38 Nm; p = 0,006) e esquerdo (134,10 ± 55,19 Nm vs. 171,05 ± 57,86 Nm; p = 0,04). O teste de caminhada de 6 minutos foi menor no grupo DRC comparado ao saudável em valor absoluto (419,95 ± 98,51m vs. 616,90 ± 90,01m; p < 0,0001) e em % do predito (66,07 ± 15,04% vs. 94,80 ± 9,35%; p < 0,0001). Observou-se correlação moderada entre a capacidade funcional e a força muscular periférica de quadrí­ceps direito (rho = 0,52; p = 0,01) e quadrí­ceps esquerdo (r = 0,63; p = 0,002) no grupo DRC. Conclusão: Pacientes com DRC apresentam alteração na função pulmonar, redução da força muscular periférica e da capacidade funcional.

Palavras-chave: doença renal crônica, diálise renal, espirometria, força muscular, tolerância ao exercí­cio.

Author Biographies

Mariana Nunes Lúcio, UDESC

Ft., Centro de Ciências da Saúde e do Esporte – CEFID/UDESC, Laboratório de Fisioterapia Respiratória – LAFIR

Ana Karla Vieira Brüggemann, UDESC

M.Sc., Centro de Ciências da Saúde e do Esporte – CEFID/UDESC, Laboratório de Fisioterapia Respiratória – LAFIR

Davi de Souza Francisco, UDESC

Ft., Centro de Ciências da Saúde e do Esporte – CEFID/UDESC, Laboratório de Fisioterapia Respiratória – LAFIR

Stefani dos Santos Marcelino, UDESC

Ft., Centro de Ciências da Saúde e do Esporte – CEFID/UDESC, Laboratório de Fisioterapia Respiratória – LAFIR

Ana Flávia Gesser, UDESC

Ft., Centro de Ciências da Saúde e do Esporte – CEFID/UDESC, Laboratório de Fisioterapia Respiratória – LAFIR

Catherine Corrêa Peruzzolo, UDESC

M.Sc., Centro de Ciências da Saúde e do Esporte – CEFID/UDESC, Laboratório de Fisioterapia Respiratória – LAFIR

Elaine Paulin, UDESC

D.Sc., Centro de Ciências da Saúde e do Esporte – CEFID/UDESC, Laboratório de Fisioterapia Respiratória – LAFIR

References

Fassbinder TRC, Winkelmann ER, Schneider J, Wendland J, Oliveira OB. Capacidade funcional e qualidade de vida de pacientes com doença renal crônica pré-dialítica e em hemodiálise - Um estudo transversal. J Bras Nefrol 2015;37(1):47-54. https://doi.org/10.5935/0101-2800.20150008

Sociedade Brasileira de Nefrologia – SBN. Censo de diálise SBN 2016. [Internet] 2016. [citado 2017 Mar 17]. Disponível em: http://www2.camara.leg.br/atividade-legislativa/comissoes/comissoes-permanentes/cssf/arquivos-de-eventos/audiencia-publica-27-04.17/milena-daher-sbn

Posser SR, Cecagno-Zanini SC, Piovesan F, Leguisamo CP. Functional capacity, pulmonary and respiratory muscle strength in individuals undergoing hemodialysis. Fisioter Mov 2016;29(2):343-50. https://doi.org/10.1590/0103-5150.029.002.AO13

Souza VA, Oliveira D, Mansur HN, Fernandes NMS, Bastos, MG. Sarcopenia na doença renal crônica. J Bras Nefrol 2015;37(1):98-105. https://doi.org/10.5935/0101-2800.20150014

Musso CG, Jauregui JR, Núñez JFM. Frailty phenotype and chronic kidney disease: a review of the literature. Int Urol Nephrol 2015;47(11):1801-7. https://doi.org/10.1007/s11255-015-1112-z

Broers NJ, Martens RJ, Cornelis T, van der Sande FM, Diederen NM, Hermans MM et al. Physical activity in end-stage renal disease patients: the effects of starting dialysis in the first 6 months after the transition period. Nephron 2017;137(1):47-56. https://doi.org/10.1159/000476072

Pereira RA, Cordeiro AC, Avesani CM, Carrero JJ, Lindholm B, Amparo FC. Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality. Nephrol Dial Transplant 2015;30(10):1718-25. https://doi.org/10.1093/ndt/gfv133

Bianchi PDA, Barreto SSM, Thomé FS, Klein AB. Repercussão da hemodiálise na função pulmonar de pacientes com doença renal crônica terminal. J Bras Nefrol 2009;31(1):25-31.

Cury JL, Brunetto AF, Aydos RD. Efeitos negativos da insuficiência renal crônica sobre a função pulmonar e a capacidade funcional. Braz J Phys Ther 2010;14(2):91-8. https://doi.org/10.1590/S1413-35552010005000008

Welch JL, Perkins SM, Johnson CS, Kraus MA. Patterns of interdialytic weight gain during the first year of hemodialysis. Nephrol Nurs J 2006;33(5):493-9.

Kovelis, D, Pitta F, Probst VS, Peres CPA, Delfino VDA, Mocelin AJ et al. Pulmonary function and respiratory muscle strength in chronic renal failure patients on hemodialysis. J Bras Pneumol 2008;34(11):907-12. https://10.1590/S1806-37132008001100004

Sietsema KE, Amato A, Adler SG, Brass EP. Exercise capacity a predictor of survival among ambulatory patients with end stage renal disease. Kidney Int 2004;65(2):719-24. https://doi.org/10.1111/j.1523-1755.2004.00411.x

Greenwood SA, Naish P, Clark R, O'connor E, Pursey VA, MacDougall et al. Intradialytic exercise training: a pragmatic approach. J Ren Care 2014;40(3):219-26. https://doi.org/10.1111/jorc.12080

Brüggemann AK, Mello CL, Dal Pont T, Kunzler HD, Martins DF, Bobinski F et al. Effects of neuromuscular electrical stimulation during hemodialysis on peripheral muscle strength and exercise capacity: a randomized clinical trial. Arch Phys Med Rehabil 2017;98(5):822-31. https://doi.org/10.1016/j.apmr.2016.12.009

Cheema BSB, Singh MAF. Exercise training in patients receiving maintenance hemodialysis: a systematic review of clinical trials. Am J Nephrol 2005;25(4):352-64. https://doi.org/10.1159/000087184

World Health Organization. WHO Obesity Technical Report Series. Obesity: preventing and managing the global epidemic. Report of a World Health Organization Consultation. Geneva: World Health Organization; 2000.

Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R et al. Standardisation of spirometry. Eur Respir J 2005;26(2):319-38. https://doi.org/10.1183/09031936.05.00034805

Pereira CADC, Sato T, Rodrigues SC. New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol 2007;33(4):397-406. https://doi.org/10.1590/S1806-37132007000400008

Murphy AJ, Wilson GJ, Pryor JF, Newton RU. Isometric assessment of muscular function: the effect of joint angle. J Applied Biomech 1995;11(2):205-15. https://doi.org/10.1123/jab.11.2.205

Smidt GL, Rogers MW. Factors contributing to the regulation and clinical assessment of muscular strength. Phys Ther 1982;62(9):1283-90. https://doi.org/10.1093/ptj/62.9.1283

Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D et al. An official European Respiratory Society/American Thoracic Society Technical Standard: field walking tests in chronic respiratory disease. Eur Respir J 2014;44(6):1521-37. https://doi.org/10.1183/09031936.00150314

Britto RR, Probst VS, Andrade AF, Samora GA, Hernandes NA, Marinho PE et al. Reference equations for the six-minute walk distance based on a Brazilian multicenter study. Braz J Phys Ther 2013;17(6):556-63. https://doi.org/10.1590/S1413-35552012005000122

Leavey SF, McCullough K, Hecking E, Goodkin D, Port FK, Young EW. Body mass index and mortality in ‘healthier’as compared with ‘sicker’haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 2010;16(12):2386-94. https://doi.org/10.1093/ndt/16.12.2386

Kemp GJ, Crowe AV, Anijeet HK, Gong QY, Bimson WE, Frostick SP. Abnormal mitochondrial function and muscle wasting, but normal contractile efficiency, in haemodialysed patients studied non-invasively in vivo. Nephrol Dial Transplant 2004;19(6):1520-27. https://doi.org/10.1093/ndt/gfh189

Sakkas GK, Sargeant AJ, Mercer TH, Ball D, Koufaki P, Karatzaferi C et al. Changes in muscle morphology in dialysis patients after 6 months of aerobic exercise training. Nephrol Dial Transplant 2003;18(9):1854-61. https://doi.org/10.1093/ndt/gfg237

Schardong TJ, Lukrafka JL, Garcia VD. Avaliação da função pulmonar e da qualidade de vida em pacientes com DRC. J Bras Nefrol 2008;30:40-7.

Pierson DJ. Respiratory considerations in the patient with renal failure. Respir Care 2006;51(4),413-22.

Karacan Ö, Tutal E, Colak T, Sezer S, Eyüboğlu FÖ, Haberal M. Pulmonary function in renal transplant recipients and end-stage renal disease patients undergoing maintenance dialysis. Transplant Proc 2006;38(2):396-400. https://doi.org/10.1016/j.transproceed.2005.12.068

Guleria S, Agarwal RK, Guleria R, Bhowmik D, Agarwal SK, Tiwari SC. The effect of renal transplantation on pulmonary function and respiratory muscle strength in patients with end-stage renal disease. Transplant Proc 2005;37(2):664-5. https://doi.org/10.1016/j.transproceed.2005.01.051

Yilmaz Z, Yildirim Y, Aydin FY, Aydin E, Kadiroglu AK, Yilmaz ME et al. Relationship between fluid status as assessed by bioimpedance analysis and NT-pro BNP, blood pressure and left ventricular mass index in hemodialysis patients. Clin Ter 2014;165(1):52-8. https://doi.org/10.7417/CT.2014.1672

Stack AG, Casserly LF. Pulmonary congestion in hemodialysis: an old chestnut worth screening for? Clin J Am Soc Nephrol 2013;8(8):1279-81. https://doi.org/10.2215/CJN.06210613

Greco A, Paroni G, Seripa D, Addante F, Dagostino MP, Aucella F. Frailty, disability and physical exercise in the aging process and in chronic kidney disease. Kidney Blood Pressure Res 2014;39(2-3):164-8. https://doi.org/10.1159/000355792

Wilhelm-Leen ER, Hall YN, Tamura MK, Chertow GM. Frailty and chronic kidney disease: the third national health and nutrition evaluation survey. Am J Med 2009;122(7):664-71. https://doi.org/10.1016/j.amjmed.2009.01.026

Roshanravan B, Robinson-Cohen C, Patel KV, Ayers E, Littman AJ, De Boer IH, et al. Association between physical performance and all-cause mortality in CKD. J Am Soc Nephrol 2013;24(5):822-30. https://doi.org/ 10.1681/ASN.2012070702

Morishita S, Tsubaki A, Shirai N. Physical function was related to mortality in patients with chronic kidney disease and dialysis. Hemodial Int 2017;21(4):483-9. https://doi.org/10.1111/hdi.12564/full

Souza VA, Oliveira D, Barbosa SR, Corrêa JOA, Colugnati FAB, Mansur HN et al. Sarcopenia in patients with chronic kidney disease not yet on dialysis: Analysis of the prevalence and associated factors. PloS One 2017;12(4):e0176230. https://doi.org/10.1371/journal.pone.0176230

Published

2019-10-24