1
|
Zhang F, Wang H, Bai Y, Huang L, Zhang H. Effect of respiratory muscle training in patients with chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2023; 37:348-361. [PMID: 36325749 DOI: 10.1177/02692155221135729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to evaluate the effect of respiratory muscle training on respiratory muscle strength, lung function, cardiopulmonary fitness, and quality of life for chronic kidney disease patients. METHODS PubMed, Embase, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials published randomized controlled trials that evaluated the effect of respiratory muscle training for chronic kidney disease patients from inception to December 2021, and rerun on September 2022. The quality of included studies was evaluated according to the Cochrane Collaboration's risk of bias tool-2. The outcomes were analyzed as mean differences with a fixed/random effect model. The strength of evidence was evaluated with the Grading of Recommendation, Assessment, Development, and Evaluation approach. RESULTS Eleven randomized controlled trials were included. All but two of the studies were in hemodialysis patients. The follow-up time range was 4 to 12 weeks. Compared to controls, respiratory muscle training significantly improved maximal expiratory pressure (mean difference = 17.36, p = 0.013), maximal inspiratory pressure (mean difference = 18.26, p = 0.002), forced expiratory volume at 1 second (mean difference = 0.20, p= 0.020), forced vital capacity (mean difference = 0.26, p = 0.008), but not for 6-minute walk test (mean difference = 39.85, p= 0.138). CONCLUSIONS As a non-pharmacological therapy, respiratory muscle training can effectively improve maximal expiratory pressure, maximal inspiratory pressure, forced expiratory volume at 1 second, and forced vital capacity in patients with chronic kidney disease and is safe for such populations.
Collapse
Affiliation(s)
- Fan Zhang
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Wang
- Department of Anorectology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Bai
- Department of Cardiology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Liuyan Huang
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huachun Zhang
- Department of Nursing, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
2
|
Francisco DDS, Peruzzolo CC, Moecke DP, Yamaguti WP, Kunzler DH, Paulin E. Influence of mild pulmonary congestion on diaphragmatic mobility and activities of daily living in chronic kidney disease: An experimental and clinical study. Nefrologia 2023; 43:81-90. [PMID: 36494284 DOI: 10.1016/j.nefroe.2022.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 12/01/2021] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Pulmonary congestion is a strong predictor of mortality and cardiovascular events in chronic kidney disease (CKD); however, the effects of the mild form on functionality have not yet been investigated. The objective of this study was to assess the influence of mild pulmonary congestion on diaphragmatic mobility (DM) and activities of daily living (ADL) in hemodialysis (HD) subjects, as well as compare ADL behavior on dialysis and non-dialysis days. In parallel, experimentally induce CKD in mice and analyze the resulting pulmonary and functional repercussions. METHODS Thirty subjects in HD underwent thoracic and abdominal ultrasonography, anthropometric assessment, lung and kidney function, respiratory muscle strength assessment and symptoms analysis. To measure ADL a triaxial accelerometer was used over seven consecutive days. Twenty male mice were randomized in Control and CKD group. Thoracic ultrasonography, TNF-α analysis in kidney and lung tissue, exploratory behavior and functionality assessments were performed. RESULTS Mild pulmonary congestion caused a 26.1% decline in DM (R2=.261; P=.004) and 20% reduction in walking time (R2=.200; P=.01), indicating decreases of 2.23mm and 1.54min, respectively, for every unit increase in lung comet-tails. Regarding ADL, subjects exhibited statistically significant differences for standing (P=.002), walking (P=.034) and active time (P=.002), and number of steps taken (P=.01) on days with and without HD. In the experimental model, CKD resulted in increased levels of TNF-α on kidneys (P=.037) and lungs (P=.02), attenuation of exploratory behavior (P=.01) and significant decrease in traveled distance (P=.034). Thoracic ultrasonography of CKD mice showed presence of B-lines. CONCLUSION The mild pulmonary congestion reduced DM and walking time in subjects undergoing HD. Individuals were less active on dialysis days. Furthermore, the experimental model implies that the presence of pulmonary congestion and inflammation may play a decisive role in the low physical and exploratory performance of CKD mice.
Collapse
Affiliation(s)
| | | | | | | | | | - Elaine Paulin
- Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil.
| |
Collapse
|
3
|
Influence of mild pulmonary congestion on diaphragmatic mobility and activities of daily living in chronic kidney disease: An experimental and clinical study. Nefrologia 2021. [DOI: 10.1016/j.nefro.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
|
4
|
Yuenyongchaiwat K, Vasinsarunkul P, Phongsukree P, Chaturattanachaiyaporn K, Tritanon O. Duration of hemodialysis associated with cardio-respiratory dysfunction and breathlessness: a multicenter study. PeerJ 2020; 8:e10333. [PMID: 33194453 PMCID: PMC7648455 DOI: 10.7717/peerj.10333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/19/2020] [Indexed: 11/25/2022] Open
Abstract
Background Patients with hemodialysis suffer with protein-energy wasting and uremic myopathy lead to lack of physical activity and poor functional performance. However, ventilation abnormality in patients undergone hemodialysis remains controversial regarding the respiratory impairment. Therefore, the study aimed to determine the effect of duration of dialysis on respiratory function. Methods A multicenter study with cross-sectional study was designed in four hemodialysis outpatient clinics. Respiratory muscle strength (i.e., maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)) pulmonary function test (i.e., forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and FEV1/FVC ratio), functional capacity (6-minute walk test) and sensation of breathlessness were assessed prior to dialysis. Results A total of 100 hemodialysis patients were recruited with 38 females and 62 males. An average of duration of hemodialysis was 5.93± 4.96 years. Decreased MIP values, FEV1 values, FVC values, %FEV1 and %FVC were noted in patients with long duration of dialysis (defined as ≥ 5 years of dialysis) compared to those with short duration of dialysis (ps < .05). In addition, increased sensation of breathlessness was observed in patients with long duration of dialysis (p < .05). Furthermore, participants with long duration of dialysis had an increased risk of ventilatory restriction (OR 6.093, p = .007).
Collapse
Affiliation(s)
- Kornanong Yuenyongchaiwat
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand.,Thammasat University Research Unit in Physical Therapy in Respiratory and Cardiovascular Systems, Thammasat University, Pathumthani, Thailand
| | - Phatsara Vasinsarunkul
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand
| | - Phoomipat Phongsukree
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand
| | | | - Opas Tritanon
- Division of Nephrology, Department of Internal medicine, Faculty of Medicine, Thammasat University, Pathumtani, Thailand
| |
Collapse
|
5
|
Mackała K, Kurzaj M, Okrzymowska P, Stodółka J, Coh M, Rożek-Piechura K. The Effect of Respiratory Muscle Training on the Pulmonary Function, Lung Ventilation, and Endurance Performance of Young Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E234. [PMID: 31905644 PMCID: PMC6981841 DOI: 10.3390/ijerph17010234] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 12/23/2019] [Accepted: 12/24/2019] [Indexed: 12/31/2022]
Abstract
This study investigated whether the addition of eight weeks of inspiratory muscle training (IMT) to a regular preseason soccer training program, including incremental endurance training (IET), would change pulmonary function, lung ventilation, and aerobic performance in young soccer players. Sixteen club-level competitive junior soccer players (mean age 17.63 ± 0.48 years, height 182 ± 0.05 cm, body mass 68.88 ± 4.48 kg) participated in the study. Participants were randomly assigned into two groups: experimental (n = 8) and control (n = 8). Both groups performed regular preseason soccer training, including endurance workouts as IET. In addition to this training, the experimental group performed additional IMT for eigght weeks with a commercially available respiratory muscle trainer (Threshold IMT), with a total of 80 inhalations (twice per day, five days per week). Pre- and post-intervention tests of pulmonary function, maximal inspiratory pressure, and the Cooper test were implemented. Eight weeks of IMT had a positive impact on expiratory muscle strength (p = 0.001); however, there was no significant effect on respiratory function parameters. The results also indicate increased efficiency of the inspiratory muscles, contributing to an improvement in aerobic endurance, measured by VO₂max estimated from running distance in the cardiorespiratory Cooper test (p < 0.005).
Collapse
Affiliation(s)
- Krzysztof Mackała
- Department of Track and Field, University School of Physical Education, Wroclaw, Ul. Paderewskiego 35, 51-612 Wrocław, Poland;
| | - Monika Kurzaj
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, Poland, Ul. Paderewskiego 35, 51-612 Wrocław, Poland; (M.K.); (P.O.); (K.R.-P.)
| | - Paulina Okrzymowska
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, Poland, Ul. Paderewskiego 35, 51-612 Wrocław, Poland; (M.K.); (P.O.); (K.R.-P.)
| | - Jacek Stodółka
- Department of Track and Field, University School of Physical Education, Wroclaw, Ul. Paderewskiego 35, 51-612 Wrocław, Poland;
| | - Milan Coh
- Faculty of Sport, University of Ljubljana, Gortanova ul. 22, 1000 Ljubljana, Slovenia;
| | - Krystyna Rożek-Piechura
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, Poland, Ul. Paderewskiego 35, 51-612 Wrocław, Poland; (M.K.); (P.O.); (K.R.-P.)
| |
Collapse
|
6
|
Andrade FP, Rezende PDS, Ferreira TDS, Borba GC, Müller AM, Rovedder PME. Effects of intradialytic exercise on cardiopulmonary capacity in chronic kidney disease: systematic review and meta-analysis of randomized clinical trials. Sci Rep 2019; 9:18470. [PMID: 31804617 PMCID: PMC6895108 DOI: 10.1038/s41598-019-54953-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 11/04/2019] [Indexed: 01/27/2023] Open
Abstract
Patients with chronic kidney disease show poorer functional and cardiorespiratory capacity than healthy individuals, and these impairments result in sedentarism. The aim of this study was to conduct a systematic review and meta-analysis of randomized clinical trials on the effects of different intradialytic exercise protocols on cardiopulmonary capacity in chronic kidney disease patients. The primary outcome was peak oxygen consumption (VO2peak) and the secondary outcomes were exercise duration and ventilation in the cardiopulmonary test. The quality of the evidence was evaluated using the GRADE guidelines. Seven studies with a total of 124 participants met the inclusion criteria. Compared to the non-exercise group, the exercise group improved in mean VO2peak (MD 4.06 [IC 0.81; 7.31]). In a separate analysis according to exercise modality, aerobic exercise plus strength training performed better than aerobic exercise alone (MD 5.28 [IC 3.90; 6.66]). In the exercise group, both exercise tolerance values (MD 3.10 [IC 1.70; 4.51]) and ventilation values in the cardiopulmonary test were better than those of the control group (MD 13.10 [IC 7.12; 19.09]). Thus, intradialytic exercise protocols can improve cardiopulmonary function, exercise tolerance and ventilatory efficiency in chronic kidney disease patients.
Collapse
Affiliation(s)
- Francini Porcher Andrade
- Programa de Pós Graduação em Ciências Pneumológicas at Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, postcode 90040-060, Brazil.
| | - Patrícia de Souza Rezende
- Physiotherapy Course, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, postcode 90040-060, Brazil
| | - Tatiane de Souza Ferreira
- Programa de Pós Graduação em Ciências Pneumológicas at Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, postcode 90040-060, Brazil
| | - Gabrielle Costa Borba
- Programa de Pós Graduação em Ciências Pneumológicas at Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, postcode 90040-060, Brazil
| | - Alice Mânica Müller
- Programa de Pós Graduação em Ciências Pneumológicas at Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, postcode 90040-060, Brazil
| | - Paula Maria Eidt Rovedder
- Programa de Pós Graduação em Ciências Pneumológicas at Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, postcode 90040-060, Brazil. .,Physiotherapy Course, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, postcode 90040-060, Brazil. .,Hospital de Clínicas de Porto Alegre, Porto Alegre, postcode 90035-903, Brazil.
| |
Collapse
|
7
|
Fukushima RLM, Micali PN, do Carmo EG, Orlandi FDS, Costa JLR. Cognitive abilities and physical activity in chronic kidney disease patients undergoing hemodialysis. Dement Neuropsychol 2019; 13:329-334. [PMID: 31555406 PMCID: PMC6753914 DOI: 10.1590/1980-57642018dn13-030010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 05/19/2019] [Indexed: 11/22/2022] Open
Abstract
Hemodialysis (HD) is a common treatment for Chronic Kidney Disease (CKD). OBJECTIVE the objective of the present study was twofold. First, to assess the level of physical activity and cognitive function in hemodialysis (HD) patients and, second, to compare cognitive function of active and insufficiently active HD patients. METHODS the sample consisted of 84 HD patients. Data collection took place in two different Renal Replacement Therapy Units (RRTU) in Brazil. A sociodemographic and clinical structured interview, the International Physical Activity Questionnaire (IPAQ) and the Addenbrooke's Cognitive Examination Revised (ACE-R) were used for data collection. The Mann Whitney U-test was used to compare cognitive function between groups. The significance level adopted was p≤.05. RESULTS the majority of the patients were insufficiently active. The total average score on the cognitive test was lower than recommended and physically active HD patients had a significant score in the fluency domain. CONCLUSION we found that HD patients are at greater risk of developing cognitive deficits. Physical activity was shown to be a potential non-pharmacological, low-cost therapeutic alternative for improving cognitive abilities in HD patients. The present study can help health professionals to encourage HD patients to engage in regular physical activity and contributes to the development of specific protocols for these patients.
Collapse
Affiliation(s)
- Raiana Lídice Mór Fukushima
- Universidade Estadual PaulistaRinggold standard institution - Physical EducationRio ClaroSPBrazilUniversidade Estadual Paulista, Ringgold standard institution - Physical Education, Rio Claro, São Paulo, SP, Brazil.
| | - Pollyanna Natalia Micali
- Universidade Estadual Paulista Julio de Mesquita FilhoRinggold standard institution - Educação FísicaRio ClaroSPBrazilUniversidade Estadual Paulista Julio de Mesquita Filho Ringgold standard institution - Educação Física Rio Claro, São Paulo, SP, Brazil.
| | - Elisangela Gisele do Carmo
- Universidade Estadual Paulista Julio de Mesquita FilhoRinggold standard institution - Educação FísicaRio ClaroSPBrazilUniversidade Estadual Paulista Julio de Mesquita Filho Ringgold standard institution - Educação Física Rio Claro, São Paulo, SP, Brazil.
| | - Fabiana de Souza Orlandi
- Universidade Federal de São PauloRinggold standard institutionSao CarlosSPBrazilUniversidade Federal de São Paulo, Ringgold standard institution, Sao Carlos, SP, Brazil.
| | - José Luiz Riani Costa
- Universidade Estadual Paulista Julio de Mesquita FilhoInstituto de BiociênciasRinggold standard institution - Instituto de BiociênciasRio ClaroSPBrazilUniversidade Estadual Paulista Julio de Mesquita Filho Instituto de Biociências Campus de Rio Claro Ringgold standard institution - Instituto de Biociências, Rio Claro, SP, Brazil.
| |
Collapse
|
8
|
El-Deen HAB, Alanazi FS, Ahmed KT. Effects of inspiratory muscle training on pulmonary functions and muscle strength in sedentary hemodialysis patients. J Phys Ther Sci 2018; 30:424-427. [PMID: 29581664 PMCID: PMC5857451 DOI: 10.1589/jpts.30.424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/15/2017] [Indexed: 01/27/2023] Open
Abstract
[Purpose] This study was conducted to evaluate the effect of Inspiratory Muscle Trainer
(IMT) on respiratory muscle strength and pulmonary functions. [Subjects and Methods]
Fifteen sedentary unemployed patients were recruited from both genders who received
regular hemodialysis sessions from at least three months. Those patients received
Threshold IMT program for 12 weeks. Pulmonary functions and respiratory muscle strength in
form of (PImax) and (PEmax) were measured by electronic spirometry and digital pressure
vacuum meter respectively. Additionally oxygen saturation was measured by Finger pulse
oximeter. All measurements were performed before and at the end of the treatment program
after 12 weeks. [Results] The results of this study revealed significant improvement in
FVC%, FEV1%, PEF%, PImax and PEmax after three months of treatment by using inspiratory
muscle trainer while no significant difference was recorded regarding to FEV1/FVC% ratio
and SpO2. [Conclusion] Inspiratory muscle trainer is an effective therapeutic
technique to improve respiratory muscle strength and pulmonary functions in patients
undergoing hemodialysis.
Collapse
Affiliation(s)
- Heba A Bahey El-Deen
- Physical Therapy Department and Health Rehabilitation, Faculty of Applied Medical Sciences, Aljouf University, Saudi Arabia.,Physical Therapy Department for Surgery, Faculty of physical Therapy, Misr University for Science and Technology, Egypt
| | - Fahad Salam Alanazi
- Physical Therapy Department and Health Rehabilitation, Faculty of Applied Medical Sciences, Aljouf University, Saudi Arabia
| | - Khaled Takey Ahmed
- Physical Therapy Department, Faculty of Health Sciences, Beirut Arab University: Beirut, Lebanon.,Physical Therapy Department for Cardiopulmonary Disorders and Geriatrics, Faculty of Physical Therapy, Misr University for Science and Technology, Egypt
| |
Collapse
|
9
|
Campos NG, Marizeiro DF, Florêncio ACL, Silva ÍC, Meneses GC, Bezerra GF, Martins AMC, Libório AB. Effects of respiratory muscle training on endothelium and oxidative stress biomarkers in hemodialysis patients: A randomized clinical trial. Respir Med 2018; 134:103-109. [DOI: 10.1016/j.rmed.2017.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/04/2017] [Accepted: 12/06/2017] [Indexed: 11/29/2022]
|
10
|
Shimomura A, Obi Y, Fazl Alizadeh R, Li S, Nguyen NT, Stamos MJ, Kalantar-Zadeh K, Ichii H. Association of pre-operative estimated GFR on post-operative pulmonary complications in laparoscopic surgeries. Sci Rep 2017; 7:6504. [PMID: 28747700 PMCID: PMC5529443 DOI: 10.1038/s41598-017-06842-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/19/2017] [Indexed: 12/22/2022] Open
Abstract
Despite a large body of evidence showing the pandemic of chronic kidney disease, the impact of pre-operative kidney function on the risk of post-operative pulmonary complications (PPCs) is not well known. We used multivariable logistic regression analyses with 3-level hierarchical adjustments to identify the association of pre-operative estimated glomerular filtration rate (eGFR) with PPCs in laparoscopic surgeries. Among 452,213 patients between 2005 and 2013 in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Database, a total of 3,727 patients (0.9%) experienced PPCs. We found a gradient association between lower eGFR and higher likelihood of PPCs in the unadjusted model. In the case-mix adjusted model, a reverse-J-shaped association was observed; a small albeit significant association with the highest eGFR category emerged. Further adjustment slightly attenuated these associations, but the PPCs risk in the eGFR groups of <30, 30-60, and ≥120 mL/min/1.73 m2 remained significant: odds ratios (95% confidence intervals) of 1.82 (1.54-2.16), 1.38 (1.24-1.54), and 1.28 (1.07-1.53), respectively (reference: 90-120 mL/min/1.73 m2). Our findings propose a need for careful pre-operative evaluation of cardiovascular and pulmonary functions and post-operative fluid management among patients with not only lower but also very high eGFR.
Collapse
Affiliation(s)
- Akihiro Shimomura
- Department of Surgery, University of California, Irvine, Orange, California, USA
| | - Yoshitsugu Obi
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology & Hypertension, University of California, Irvine, Orange, California, USA.
| | - Reza Fazl Alizadeh
- Department of Surgery, University of California, Irvine, Orange, California, USA
| | - Shiri Li
- Department of Surgery, University of California, Irvine, Orange, California, USA
| | - Ninh T Nguyen
- Department of Surgery, University of California, Irvine, Orange, California, USA
| | - Michael J Stamos
- Department of Surgery, University of California, Irvine, Orange, California, USA
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology & Hypertension, University of California, Irvine, Orange, California, USA
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
- Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles, Torrance, California, USA
| | - Hirohito Ichii
- Department of Surgery, University of California, Irvine, Orange, California, USA.
| |
Collapse
|
11
|
The role of the inspiratory muscle weakness in functional capacity in hemodialysis patients. PLoS One 2017; 12:e0173159. [PMID: 28278163 PMCID: PMC5344350 DOI: 10.1371/journal.pone.0173159] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 02/15/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction Inspiratory muscle function may be affected in patients with End-Stage Renal Disease (ESRD), further worsening the functional loss in these individuals. However, the impact of inspiratory muscle weakness (IMW) on the functional capacity (FC) of hemodialysis patients remains unknown. Thus, the present study aimed to evaluate the impact of IMW on FC in ESRD patients undergoing hemodialysis. Materials and methods ESRD patients on hemodialysis treatment for more than six months were evaluated for inspiratory muscle strength and FC. Inspiratory muscle strength was evaluated based on maximal inspiratory pressure (MIP). IMW was defined as MIP values less than 70% of the predicted value. FC was evaluated using the Incremental Shuttle Walk test (ISWT). Patients whose predicted peak oxygen uptake (VO2peak) over the distance walked during the ISWT was less than 16mL/kg/min were considered to have FC impairment. Associations between variables were assessed by linear and logistic regression, with adjustment for age, sex, body mass index (BMI), presence of diabetes and hemoglobin level. Receiver-operating characteristic (ROC) analysis was used to determine different cutoff values of the MIP for normal inspiratory muscle strength and FC. Results Sixty-five ERSD patients (67.7% male), aged 48.2 (44.5–51.9) years were evaluated. MIP was an independent predictor of the distance walked during the ISWT (R2 = 0.44). IMW was an independent predictor of VO2peak < 16mL/kg/min. (OR = 5.7; p = 0.048) in adjusted logistic regression models. ROC curves showed that the MIP cutoff value of 82cmH2O had a sensitivity of 73.5% and specificity of 93.7% in predicting normal inspiratory strength and a sensitivity and specificity of 76.3% and 70.4%, respectively, in predicting VO2peak ≥ 16mL/kg/min. Conclusions IMW is associated with reduced FC in hemodialysis patients. Evaluation of the MIP may be important to functional monitoring in clinical practice and can help in the stratification of patients eligible to perform exercise testing.
Collapse
|
12
|
Medeiros NCBD, Silva JDS, Oliveira NPDD, Cavalcante ARS, Gonçalves CT, Magnani KL. Effects of non-invasive ventilatory support in tolerance to the effort of patients with hemodialysis. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.001.ao16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction The kidney system is responsible for the maintenance of homeostasis and in patients with Chronic Kidney Disease the kidney functions changes, contributing for the development of various complications that will have adverse effects in tolerance to the physical exercise and in Quality of Life of this patients. Objective To evaluate the Effects of non-invasive ventilatory support in tolerance to the patients’ physical exercise in dialysis. Methods The patients performed two 6-minute walk tests, following an adapted protocol for treadmill, one of them without the use of non-invasive ventilatory support and the other with non-invasive ventilatory support during the walk. Besides, the patients answered a questionnaire of quality of life and the KDQOL-SFTM specific for the population under study. Results It was noticed that there was not statistical difference in the distance recorded during the 6-minute walk tests. Regarding the quality of life, the greater impact of the disease was in relation to “Professional Activity”. Conclusion In conclusion, a non-invasive ventilatory support did not cause significant effects in tolerance to the exercise of this population. However, we should take into consideration the limitations suffered during the research development.
Collapse
Affiliation(s)
| | | | | | | | | | - Karla Luciana Magnani
- Universidade Federal do Rio Grande do Norte, Brazil; Universidade Estadual Paulista, Brazil
| |
Collapse
|
13
|
Yılmaz S, Yildirim Y, Yilmaz Z, Kara AV, Taylan M, Demir M, Coskunsel M, Kadiroglu AK, Yilmaz ME. Pulmonary Function in Patients with End-Stage Renal Disease: Effects of Hemodialysis and Fluid Overload. Med Sci Monit 2016; 22:2779-84. [PMID: 27497672 PMCID: PMC4979594 DOI: 10.12659/msm.897480] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Respiratory system disorders are one of the most prevalent complications in end-stage renal disease patients on hemodialysis. However, the pathogenesis of impaired pulmonary functions has not been completely elucidated in these patients. We designed a study to investigate acute effects of hemodialysis treatment on spirometry parameters, focusing on the relationship between pulmonary function and fluid status in hemodialysis patients. Material/Methods We enrolled 54 hemodialysis patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status before and 30 min after the midweek of hemodialysis (HD). Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was defined as OH/ECW ≥7%. Spirometry was performed before and after hemodialysis. Results Forced vital capacity (FVC), FVC%, and forced expiratory volume in the first second (FEV1) levels were significantly increased after hemodialysis. FVC, FVC%, FEV1, FEV1%, mean forced expiratory flow between 25% and 75% of the FVC (FEF25–75), FEF25–75%, peak expiratory flow rate (PEFR), and PEFR% were significantly lower in patients with fluid overload than in those without. OH/ECW ratio was negatively correlated with FVC, FVC%, FEV1, FEV1%, FEF25–75, FEF25–75%, PEFR, and PEFR%. Stepwise multiple regression analysis revealed that male sex and increased ultrafiltration volume were independently associated with higher FVC, whereas increased age and OH/ECW ratio were independently associated with lower FVC. Conclusions Fluid overload is closely associated with restrictive and obstructive respiratory abnormalities in HD patients. In addition, hemodialysis has a beneficial effect on pulmonary function tests, which may be due to reduction of volume overload.
Collapse
Affiliation(s)
- Süreyya Yılmaz
- Department of Chest Diseases and Tuberculosis, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
| | - Yasar Yildirim
- Department of Nephrology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
| | - Zülfükar Yilmaz
- Department of Nephrology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
| | - Ali Veysel Kara
- Department of Nephrology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
| | - Mahsuk Taylan
- Department of Chest Diseases and Tuberculosis, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
| | - Melike Demir
- Department of Chest Diseases and Tuberculosis, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
| | - Mehmet Coskunsel
- Department of Chest Diseases and Tuberculosis, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
| | - Ali Kemal Kadiroglu
- Department of Nephrology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
| | - Mehmet Emin Yilmaz
- Department of Nephrology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
| |
Collapse
|
14
|
Pomidori L, Lamberti N, Malagoni AM, Manfredini F, Pozzato E, Felisatti M, Catizone L, Barillà A, Zuccalà A, Tripepi G, Mallamaci F, Zoccali C, Cogo A. Respiratory muscle impairment in dialysis patients: can minimal dose of exercise limit the damage? A Preliminary study in a sample of patients enrolled in the EXCITE trial. J Nephrol 2016; 29:863-869. [PMID: 27312989 DOI: 10.1007/s40620-016-0325-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/05/2016] [Indexed: 10/21/2022]
Abstract
AIM Skeletal muscle atrophy and dysfunction with associated weakness may involve the respiratory muscles of dialysis patients. We evaluated the effect of moderate-intensity exercise on lung function and respiratory muscle strength. METHODS Fifty-nine patients (25 F, aged 65 ± 13 years) from two centers participating in the multicenter randomized clinical trial EXerCise Introduction To Enhance Performance in Dialysis (EXCITE) were studied. Subjects were randomized into a prescribed exercise group (E), wherein subjects performed two 10-min walking sessions every second day at an intensity below the self-selected speed, or a control group (C) with usual care. Physical performance was assessed by the 6-min walk test (6MWT). Patient lung function and respiratory muscle strength were evaluated by spirometry and maximal inspiratory pressure (MIP), respectively. RESULTS Forty-two patients (14 F) completed the study. At baseline, the groups did not differ in any parameters. In total, 7 patients (4 in E; 3 in C) showed an obstructive pattern. The pulmonary function parameters were significantly correlated with 6MWT but not with any biochemical measurements. Group E safely performed the exercise program. At follow-up, the spirometry parameters did not change in either group. A deterioration of MIP (-7 %; p = 0.008) was observed in group C, but not in group E (+3.3 %, p = ns). In E, an increase of 6MWT was also found (+12 vs. 0 % in C; p = 0.038). CONCLUSION In dialysis patients, a minimal dose of structured exercise improved physical capacity and maintained a stable respiratory muscle function, in contrast to the control group where it worsened.
Collapse
Affiliation(s)
- Luca Pomidori
- Biomedical Sport Studies Centre, University of Ferrara, Ferrara, Italy. .,Esercizio Vita ONLUS, Via Don Giovanni Calabria 13, 44124, Ferrara, Italy.
| | - Nicola Lamberti
- Department of Biomedical and Surgical Specialties Sciences, Section of Sport Sciences, University of Ferrara, Ferrara, Italy
| | - Anna Maria Malagoni
- Biomedical Sport Studies Centre, University of Ferrara, Ferrara, Italy.,Unit of Translational Surgery, Hospital University of Ferrara, Ferrara, Italy
| | - Fabio Manfredini
- Department of Biomedical and Surgical Specialties Sciences, Section of Sport Sciences, University of Ferrara, Ferrara, Italy
| | - Enrico Pozzato
- Biomedical Sport Studies Centre, University of Ferrara, Ferrara, Italy.,Esercizio Vita ONLUS, Via Don Giovanni Calabria 13, 44124, Ferrara, Italy
| | - Michele Felisatti
- Biomedical Sport Studies Centre, University of Ferrara, Ferrara, Italy.,Esercizio Vita ONLUS, Via Don Giovanni Calabria 13, 44124, Ferrara, Italy
| | - Luigi Catizone
- Nephrology Dialysis Unit, Hospital University of Ferrara, Ferrara, Italy
| | - Antonio Barillà
- Nephrology Dialysis Unit, Hospital University of Ferrara, Ferrara, Italy
| | | | - Giovanni Tripepi
- CNR-IFC, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy
| | - Francesca Mallamaci
- CNR-IFC, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy.,Nephrology and Renal Transplantation Division, Ospedali Riuniti, Reggio Calabria, Italy
| | - Carmine Zoccali
- Nephrology and Renal Transplantation Division, Ospedali Riuniti, Reggio Calabria, Italy
| | - Annalisa Cogo
- Biomedical Sport Studies Centre, University of Ferrara, Ferrara, Italy.,Department of Biomedical and Surgical Specialties Sciences, Section of Sport Sciences, University of Ferrara, Ferrara, Italy
| |
Collapse
|
15
|
Posser SR, Cecagno-Zanini SC, Piovesan F, Leguisamo CP. Functional capacity, pulmonary and respiratory muscle strength in individuals undergoing hemodialysis. FISIOTERAPIA EM MOVIMENTO 2016. [DOI: 10.1590/0103-5150.029.002.ao13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Individuals with chronic kidney disease (CKD) undergoing hemodialysis (HD) present low cardiorespiratory fitness and functional capacity. Metabolic changes, due to the disease, can result in a variety of pathophysiological conditions that favor the development of respiratory muscle weakness. However, very little is known about the performance of the respiratory muscles and the influence of HD on them. Aim: To evaluate and correlate pulmonary function, functional capacity and respiratory muscle strength in patients with CKD undergoing HD. Methods: Cross-sectional study comprising 23 patients with CKD, that met the following inclusion criteria: patients of both genders, who perform HD three times a week for a minimum period of three months. Respiratory muscle strength was evaluated using a respiratory pressure meter, lung function through spirometry and functional capacity through the 6-minute walk test (6MWT) before the HD session. Results: All patients were male and mean age was 50.2 ± 15.8 years. The median duration of HD was 3 (1.5 to 6.0) years. The mean values obtained in comparison to those predicted were MIP% 36.0 ± 13.6, MEP% 49.5 ± 15.8, FVC% 93.8 ± 21.1, FEV1% 93.7 ± 21.1, FVC/VEF1% 104.1 ± 10.3, and 6MWT% 66.33 ± 20.53. A statistically significant positive correlation was observed between the 6MWT and MIP (r = .63, p =.001) and MEP (r = .67, p < .001), between the MIP and MEP (r =.79, p < .001) and between the FEV1 and FVC (r = .91, p < .001). Conclusion: Patients with CKD undergoing HD present changes in respiratory muscle strength, with the predicted values decreasing for age and gender, as well as the distance covered in the 6MWT, although, with normal spirometric values. Functional capacity was dependent on respiratory muscle strength, as well as the values of MIP and MEP, and the values of FVC and FEV1.
Collapse
|
16
|
Plesner LL, Warming PE, Nielsen TL, Dalsgaard M, Schou M, Høst U, Rydahl C, Brandi L, Køber L, Vestbo J, Iversen K. Chronic obstructive pulmonary disease in patients with end-stage kidney disease on hemodialysis. Hemodial Int 2015; 20:68-77. [DOI: 10.1111/hdi.12342] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Louis L. Plesner
- Department of Cardiology; Herlev Hospital, Copenhagen University Hospital; Copenhagen Denmark
- Department of Cardiology, Endocrinology and Nephrology; Nordsjaellands Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - Peder E. Warming
- Department of Cardiology; Herlev Hospital, Copenhagen University Hospital; Copenhagen Denmark
- Department of Cardiology, Endocrinology and Nephrology; Nordsjaellands Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - Ture L. Nielsen
- Department of Cardiology, Endocrinology and Nephrology; Nordsjaellands Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - Morten Dalsgaard
- Department of Cardiology; Herlev Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - Morten Schou
- Department of Cardiology; Herlev Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - Ulla Høst
- Department of Cardiology; Herlev Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - Casper Rydahl
- Department of Nephrology; Herlev Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - Lisbet Brandi
- Department of Cardiology, Endocrinology and Nephrology; Nordsjaellands Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - Lars Køber
- Department of Cardiology; Rigshospitalet, Copenhagen University Hospital; Copenhagen Denmark
| | - Jørgen Vestbo
- Department of Respiratory Medicine; Gentofte Hospital, Copenhagen University Hospital; Copenhagen Denmark
- Respiratory and Allergy Research Group; Manchester Academic Health Science Centre; University Hospital South Manchester NHS Foundation Trust; Manchester UK
| | - Kasper Iversen
- Department of Cardiology; Herlev Hospital, Copenhagen University Hospital; Copenhagen Denmark
| |
Collapse
|
17
|
Ashour L, Wagih K, Atef H, Bichari W, Fathya D. Assessment of respiratory muscles’ performance in patients with chronic renal failure immediately before and after hemodialysis. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2014. [DOI: 10.4103/1687-8426.145699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
18
|
Fernandes MIDCD, Medeiros ABDA, Macedo BMD, Vitorino ABF, Lopes MVDO, Lira ALBDC. [Prevalence of nursing diagnosis of fluid volume excess in patients undergoing hemodialysis]. Rev Esc Enferm USP 2014; 48:446-53. [PMID: 25076272 DOI: 10.1590/s0080-623420140000300009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 04/16/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify the prevalence of nursing diagnosis of fluid volume excess and their defining characteristics in hemodialysis patients and the association between them. METHOD Cross-sectional study conducted in two steps. We interviewed 100 patients between the months of December 2012 and April 2013 in a teaching hospital and one hemodialysis clinic. The inference was performed by diagnostician nurses between July and September 2013. RESULTS The diagnostic studied was identified in 82% of patients. The characteristics that were statistically associated: bounding pulses, pulmonary congestion, jugular vein distention, edema, change in electrolytes, weight gain, intake greater than output and abnormal breath sounds. Among these, edema and weight gain had the highest chances for the development of this diagnostic. CONCLUSION The analyzed diagnostic is prevalent in this population and eight characteristics presented significant association.
Collapse
|
19
|
Impact of hemodialysis on dyspnea and lung function in end stage kidney disease patients. BIOMED RESEARCH INTERNATIONAL 2014; 2014:212751. [PMID: 24895552 PMCID: PMC4034396 DOI: 10.1155/2014/212751] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 02/13/2014] [Indexed: 11/24/2022]
Abstract
Background. Respiratory symptoms are usually underestimated in patients with chronic kidney disease undergoing maintenance hemodialysis. Therefore, we set out to investigate the prevalence of patients chronic dyspnea and the relationship of the symptom to lung function indices. Methods. Twenty-five clinically stable hemodialysis patients were included. The mMRC dyspnea scale was applied before and after hemodialysis. Spirometry, single breath nitrogen test, arterial blood gases, static maximum inspiratory (Pimax) and expiratory (Pemax) muscle pressures, and mouth occlusion pressure (P0.1) were also measured. Results. Despite normal spirometry, all patients (100%) reported mild to moderate degree of chronic dyspnea pre which was reduced after hemodialysis. The sole predictor of (Δ) mMRC was the (Δ) P0.1 (r = 0.71, P < 0.001). The Pimax was reduced before and correlated with the duration of hemodialysis (r = 0.614, P < 0.001), whilst after the session it was significantly increased (P < 0.001). Finally (Δ) weight was correlated with the (Δ) Pimax %pred (r = 0.533, P = 0,006) and with the (Δ) CV (%pred) (r = 0.65, P < 0.001). Conclusion. We conclude that dyspnea is the major symptom among the CKD patients that improves after hemodialysis. The neuromechanical dissociation observed probably is one of the major pathophysiologic mechanisms of dyspnea.
Collapse
|
20
|
Siviero PCL, Machado CJ, Cherchiglia ML. Insuficiência renal crônica no Brasil segundo enfoque de causas múltiplas de morte. ACTA ACUST UNITED AC 2014. [DOI: 10.1590/1414-462x201400010012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Este estudo investiga a mortalidade por doença renal crônica (DRC) por meio das causas múltiplas de morte no Brasil e apresenta a análise de associação entre as causas de óbitos de pacientes em terapia renal substitutiva (TRS), considerando causas associadas de morbimortalidade e características epidemiológicas e sociodemográficas. Utilizou-se a base nacional em TRS centrada no indivíduo para os anos de 2000 a 2004 e a técnica multivariada Grade of Membership(GoM). Os resultados apontam quatro perfis: doenças transmissíveis, doenças glomerulares e do aparelho digestivo; lesões, envenenamentos e outras consequências de causas externas e reação anormal ou complicação tardia causadas por procedimentos cirúrgicos (hemodiálise); diabetes e doenças cardiovasculares; e perfil residual. Entre os resultados destaca-se que aproximadamente 48% dos óbitos decorreram, provavelmente, de complicações do tratamento (hemodiálise) e 39%, de diabetes, além de uma condição cardiovascular na declaração de óbito. Os achados deste estudo podem contribuir para um atendimento mais adequado dos pacientes com DRC e, principalmente, dos potenciais pacientes no sistema de saúde. A prevenção e o acompanhamento das doenças associadas, especialmente diabetes e hipertensão, têm papel importante na prevenção e progressão da DRC, que é uma doença complexa e exige múltiplas abordagens de tratamento.
Collapse
|
21
|
Lin H, Wu YG, Zhang JH, Kan M. High-flux dialysis improves pulmonary ventilation function in uremic patients. Mol Med Rep 2013; 7:1603-6. [PMID: 23504065 DOI: 10.3892/mmr.2013.1373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 03/05/2013] [Indexed: 11/06/2022] Open
Abstract
Lung injury commonly accompanies uremia caused by renal failure. Uremia is typically treated using hemodialysis (dialysis) to restore electrolyte and fluid balance. A more recent, less commonly used method, high-flux dialysis, has not yet been investigated for its potential benefit to lung function. The aim of the present study was to determine whether high‑flux dialysis affects pulmonary function. We assessed various pulmonary function parameters in patients with uremia before and after routine or high‑flux dialysis. Pulmonary function was assessed via determination of the forced vital capacity (FVC), maximum breathing capacity (MBC), forced expiratory volume in 1 sec (FEV1), peak expiratory flow (PEF), maximal midexpiratory flow (MMEF) curve, maximal expiratory flow in 25% vital capacity (V25) and diffusion capacity of the lungs for carbon monoxide (DLco) in 42 patients with uremia and 24 healthy individuals. Patients with uremia were divided into two groups; the high‑flux group (treated with high-flux dialysis; n=21) and the routine group (treated with conventional dialysis; n=21). Lung function was reassessed in the two groups after 3 months of dialysis. The two groups of patients with uremia exhibited reduced lung function parameters compared with healthy individuals (all P<0.05), indicating the presence of impaired lung function secondary to uremia. Following dialysis, the FEV1, PEF, MMEF and V25 values increased significantly compared with their respective baseline values prior to treatment for each group (ANOVA, P<0.05). Furthermore, increases were more marked in patients treated with high-flux dialysis compared with those treated using routine dialysis (P<0.05). Thus, lung injury caused by uremia was shown to be improved following dialysis, with high-flux dialysis offering a greater benefit than routine dialysis.
Collapse
Affiliation(s)
- Hui Lin
- Division of Nephrology, Department of Internal Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230001, P.R. China
| | | | | | | |
Collapse
|
22
|
Figueiredo RR, Castro AAM, Napoleone FMGG, Faray L, de Paula Júnior AR, Osório RAL. Respiratory biofeedback accuracy in chronic renal failure patients: a method comparison. Clin Rehabil 2012; 26:724-32. [DOI: 10.1177/0269215511431088] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To analyse respiratory biofeedback effects on respiratory muscle strengthening in chronic renal failure patients. Design: Randomized controlled study. Setting: Nephrology and dialysis centre. Subjects and intervention: Forty-one end-stage renal patients on haemodialysis treatment were allocated into three groups: control ( n = 10), G-1 (inspiratory muscle training using Threshold IMT device; n = 16) and G-2 (biofeedback; n = 15) and given respiratory muscle training (three sessions/week for six weeks). Main measures: Forced vital capacity (FVC), expiratory volume in the first second (FEV1), FEV1/FVC ratio, maximal voluntary ventilation (MVV) and maximal inspiratory (MIP) and expiratory (MEP) pressures were measured before and after the respiratory muscle training programme. Results: Both training methods were efficient since we found an increase after training in the FVC in the G-1 group (from 2.45 ± 0.17 to 2.85 ± 0.16; P = 0.001) and in the G-2 group (from 2.35 ± 0.19 to 2.55 ± 0.19; P = 0.007), in the FEV1 in G-1 (from 2.18 ± 0.16 to 2.46 ± 0.14; P = 0.01) and in G-2 (from 1.97 ± 0.17 to 2.20 ± 0.15; P < 0.0001), MIP in G-1 (from 70.63 ± 4.03 to 108.75 ± 7.41; P < 0.0001) and in G-2 (from 67.67 ± 5.02 to 96.33 ± 8.30; P < 0.001) and MEP in G-1 (from 73.13 ± 5.10 to 82.50 ± 6.74; P = 0.007) and in G-2 (from 67.67 ± 5.41 to 76.00 ± 4.29; P = 0.002). Conclusions: Respiratory biofeedback is efficient as a respiratory muscle training modality for patients with chronic renal failure.
Collapse
|
23
|
Soares KTDA, Viesser MV, Rzniski TAB, Brum EP. Eficácia de um protocolo de exercícios físicos em pacientes com insuficiência renal crônica, durante o tratamento de hemodiálise, avaliada pelo SF-36. FISIOTERAPIA EM MOVIMENTO 2011. [DOI: 10.1590/s0103-51502011000100015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Analisar os efeitos de um protocolo de exercícios fisioterapêuticos em pacientes renais crônicos, durante a terapia hemodialítica, visando à melhora de sua qualidade de vida. MATERIAIS E MÉTODOS: Foram avaliados 27 pacientes, com idade média de 51 ± 10,5 anos, índice de massa corpórea média de 24,3 ± 3,8 e em tratamento hemodialítico há aproximadamente 50 ± 27,7 meses. Os pacientes assinaram o Termo de Consentimento Livre e Esclarecido e, durante três meses, participaram de um programa de tratamento, durante a hemodiálise, composto por alongamentos musculares de membros inferiores, de membro superior (que não apresentasse a fístula arteriovenosa), lombar e cervical (caso o paciente não apresentasse o cateter cervical de diálise); fortalecimentos musculares de membros inferiores e membro superior, sem o acesso vascular; e relaxamento. Foi aplicado o questionário de qualidade de vida SF-36 antes e após o período de tratamento. RESULTADOS: Após o tratamento, o teste SF-36 mostrou melhora significativa das seguintes variáveis: capacidade funcional, nível de dor, vitalidade e saúde mental. Também foi observado que, antes do tratamento, dez pacientes relatavam cãibras musculares e, após a fisioterapia, somente quatro pacientes continuaram relatando essas contrações. CONCLUSÃO: Conclui-se que a atuação da fisioterapia durante a hemodiálise contribuiu para a melhora da qualidade de vida de pacientes renais crônicos.
Collapse
|
24
|
Dipp T, Silva AMVD, Signori LU, Strimban TM, Nicolodi G, Sbruzzi G, Moreira PR, Plentz RDM. Força muscular respiratória e capacidade funcional na insuficiência renal terminal. REV BRAS MED ESPORTE 2010. [DOI: 10.1590/s1517-86922010000400002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Verificar a associação da força muscular respiratória com a capacidade funcional, força proximal de membros inferiores e variáveis bioquímicas em pacientes em hemodiálise (HD). MÉTODOS: Participaram deste estudo 30 indivíduos (18 homens), com 53,4 ± 12,9 anos e tempo de HD de 41,1 ± 55,7 meses. Foram avaliados pressão inspiratória máxima (PImax), pressão expiratória máxima (PEmax), distância percorrida no teste de caminhada de seis minutos (6MWT), número de repetições no teste de sentar-e-levantar em 30 segundos (TSL) e registrados os exames bioquímicos de rotina no serviço. RESULTADOS: Houve diminuição da PEmax em relação aos valores preditos (p = 0,015) e redução na distância percorrida no 6MWT quando comparados com equações de predição (p < 0,001). O logPImax e o logPEmax correlacionaram-se com o número de repetições no TSL (r = 0,476, p = 0,008; r = 0,540, p = 0,002, respectivamente), e com os níveis séricos de fósforo (r = 0,422, p = 0,020; r = 0,639, p < 0,001, respectivamente). A distância no 6MWT correlacionou-se com o logPEmax (r = 0,511; p = 0,004) e com o número de repetições no TSL (r = 0,561; p = 0,001). CONCLUSÃO: A redução da PEmax em pacientes com IRT em HD está associada à capacidade funcional, força proximal de membros inferiores e níveis de fósforo sérico, podendo representar, pelo menos em parte, o baixo desempenho físico-funcional desses pacientes.
Collapse
|
25
|
Fregadolli P, Sasseron AB, Lanzoni KC, Figueiredo LCD, Cardoso AL, Lima NMFV. Comparação entre o uso de bocal e máscara facial na avaliação de volumes pulmonares e capacidade vital em indivíduos saudáveis. FISIOTERAPIA E PESQUISA 2010. [DOI: 10.1590/s1809-29502010000100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Testes de função pulmonar são usados para determinar a gravidade, as conseqüências funcionais e o progresso de disfunções pulmonares e neuromusculares. As variações metodológicas com o bocal e a máscara facial e a cooperação do paciente podem interferir no desempenho das manobras e afetar as medidas. O objetivo deste estudo foi comparar os valores de volumes pulmonares (volume corrente [Vc], volume-minuto [Vm]), freqüência respiratória (FR) e capacidade vital (CV) em indivíduos saudáveis quando avaliados por meio do bocal e da máscara facial. Participaram do estudo 60 voluntários saudáveis, 14 homens e 46 mulheres, com média de idade de 22,9±7,1 anos. Para a avaliação com bocal, utilizou-se uma peça semirrígida descartável e clipe nasal; a máscara usada foi facial plástica com borda pneumática inflável. As medidas obtidas foram comparadas estatisticamente (nível de significância 5%). Os valores obtidos com o bocal e com a máscara facial foram, respectivamente: FR, 15 rpm x 13 rpm (p<0,01); Vm, 14,87 l/min x 10,02 l/min (p<0,01); Vc, 0,93 l x 0,8 l (p<0,01); CV, 3,85 l x 3,52 l (p<0,01). Os valores de volumes pulmonares e capacidade vital mostraram-se pois significativamente inferiores quando avaliados com a máscara facial em comparação ao bocal.
Collapse
|