El efecto de una sesión de entrenamiento en pacientes con enfermedad renal crónica

Una revisión sistemática

Resumen

Introducción: La Enfermedad Renal Crónica (ERC) es conocida por sus proporciones epidémicas a nivel mundial. En 2017, la prevalencia fue del 9,1% (aproximadamente 697.5000.000 de casos). Objetivo: Analizar el efecto de una sesión de entrenamiento en diferentes estadios de la ERC, describiendo protocolos y resultados clínicos. Métodos: La revisión se realizó de acuerdo con la guía PRISMA, registrada en PROSPERO (Nº CRD 42020222701). Las estrategias de búsqueda se realizaron en las bases de datos electrónicas LILACS, MEDLINE (acceso a través de PubMed), PEDro, SciELO y ScienceDirect. Como criterio de inclusión se utilizó la estrategia PICO(S) en la sesión de entrenamiento y para presentar medidas de variables que potencialmente responden a la sesión de entrenamiento. La evaluación de la calidad de los estudios se realizó mediante RevMan (versión 5.3). Resultados y discusión: La búsqueda resultó en 72 artículos, y después de todos los pasos de selección, 10 cumplieron con los requisitos. En cuanto al momento en que se realizó la intervención, cinco estudios (50%) realizaron la intervención durante la intradiálisis, cuatro (40%) presentaron la sesión de entrenamiento con pacientes en etapas que preceden al tratamiento de diálisis y uno (10%) pre y post-trasplante. La duración de la sesión de entrenamiento varió de 20 a 48 minutos y la intensidad fue de baja a alta. Se verifica la falta de estandarización en tipo de ejercicio e intensidad. Conclusión: Es posible que una sesión de entrenamiento pueda tener efectos beneficiosos en un corto período de tiempo, favoreciendo la condición clínica de los pacientes.

Palabras clave: Insuficiencia renal crónica, Diálisis de riñón, Ejercicio

Referencias

Akobeng, A.K. (2005). Principles of evidence based medicine. Archives of Disease in Childhood, 90(8), 837-840. http://dx.doi.org/10.1136/adc.2005.071761

Alcalde, P.R., e Gianna, M.K. (2018). Expenses of the Brazilian Public Healthcare System with Chronic Kidney Disease. Brazilian Journal of Nephrology, 40(2), 122-129. https://doi.org/10.1590/2175-8239-JBN-3918

Alelign, T., e Petros, B. (2018). Kidney stone disease: an update on current concepts. Advances in Urology, 1-12. https://doi.org/10.1155/2018/3068365

Arazi, H., Mohabbat, M., Saidie, P., Falahati, A., e Suzuki, K. (2022). Effects of Different Types of Exercise on Kidney Diseases. Sports, 10(42), 1-29. http://dx.doi.org/10.3390/sports10030042

Bohm, C., Stewart, K., Onyskie-Marcus, J., Esliger, D., Kriellaars, D., e Rigatto, C. (2014). Effects of intradialytic cycling compared with pedometry on physical function in chronic outpatient hemodialysis: a prospective randomized trial. Nephrology Dialysis Transplantation, 29(10), 1947-1955. https://doi.org/10.1093/ndt/gfu248

Bohm, J., Monteiro, M.B., Andrade, F.P., Veronese, F.V., e Thome, F. (2017). Acute effects of intradialytic aerobic exercise on solute removal, blood gases and oxidative stress in patients with chronic kidney disease. Brazilian Journal of Nephrology, 39(2), 172-180. http://dx.doi.org/10.5935/0101-2800.20170022

Borg, G.A. (1982). Psychophysical bases of perceived exertion. Med Sci Sports Exerc., 14(5), 377-281. https://pubmed.ncbi.nlm.nih.gov/7154893/

Brown, P.D.S., Rowed, K., Shearer, J., MacRae, J.M., e Parker, K. (2018). Impact of intradialytic exercise intensity on urea clearance in hemodialysis patients. Appl Physiol Nutr Metab., 43, 101-104. https://doi.org/10.1139/apnm-2017-0460

Caracas, D.R.S., Lima, D.B., Santos, G.F., Sousa, M.A., y Cruz, C.M.S. (2017). Prevalência de risco cardiovascular e nível de atividade física em pacientes com doença renal crônica em tratamento hemodialitico. Revista Saúde.com, 13(2), 871-878. http://dx.doi.org/10.22481/rsc.v13i2.420

Carvalho, A.P.V., Silva, V., e Grande, A.J. (2013). Avaliação do risco de viés de ensaios clínicos randomizados pela ferramenta da colaboração Cochrane. Diagn Tratamento, 18(1), 28-44. https://www.researchgate.net/publication/306151902

Cavalcanti, APS, Ferreira, RS, Silva, MR, Kimura, CSFG, Vieira, ECB, Marui, FRRH, e Mazzieri, ML (2021). Fatores de risco para complicações cardiovasculares em pacientes em tratamento hemodialítico. Glob Acad Nurs. 2(3), e166. https://doi.org/10.5935/2675-5602.20200166

Cockcroft, D.W., e Gault, H. (1976). Prediction of creatinine clearance from serum creatinine. Nephron., 16 (1), 31-41. https://doi.org/10.1159/000180580

Coletta, DK, Campbell, LE, Weil, J., Kaplan, B., Clarkson, M., Finlayson, J., Mandarino, LJ, e Chakkera, HA (2016). Change in pre- and post-exercise gene expression among patients with chronic kidney disease and kidney transplant recipients. PLoS ONE, 11(8), e0160327. https://doi.org/10.1371/journal.pone.0160327

Fatouros, IG, Pasadakis, P., Sovatzidis, A., Chatzinikolaou, A., Panagoutsos, S., Sivridis, D., Michailidis, I., Douroudos, I., Taxildaris, K., e Vargemezis, V. (2008). Acute exercise may exacerbate oxi¬dative stress response in hemodialysis patients. Nephron Clin Pract., 109, 55-64. https://doi.org/10.1159/000139990

Fuhro, M.I. (2018). Acute exercise during hemodialysis prevents the decrease in natural killer cells in patients with chronic kidney disease: a pilot study. International Urology and Nephrology, 50, 527-534. https://doi.org/10.1007/s11255-017-1747-z

Giannaki, CD, Hadjigeorgiou, GM, Karatzaferi, C., Maridaki, MD, Koutedakis, Y., Founta, P., Tsianas, N., Stefanidis, I., e Sakkas, GK (2013). A single-blind randomized controlled trial to evaluate the effect of 6 months of progressive aerobic exercise training in patients with uraemic restless legs syndrome. Nephrology Dialysis Transplantation, 28(11), 2834-2840. https://doi.org/10.1093/ndt/gft288

Gomes, T.S., Aoike, D.T., Baria, F., Graciolli, F.G., Moyses, R.M.A., e Cuppari, L. (2017). Effect of Aerobic Exercise on Markers of Bone Metabolism of Overweight and Obese Patients with Chronic Kidney Disease. J. Ren. Nutr. , 27, 364-371. https://doi.org/10.1053/j.jrn.2017.04.009

Huang, M., Lv, A., Wang, J., Zhang, B., Xu, N., Zhai, Z., Gao, J., Wang, Y., Li, T., e Ni, C. (2020). The effect of intradialytic combined exercise on hemodialysis efficiency in end stage renal disease patients: a randomized controlled trial. International Urology and Nephrology, 52, 969-976. https://doi.org/10.1007/s11255-020-02459-1

KDIGO (2013). Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl., 3, 1-150. https://kdigo.org/wp-content/uploads/2017/02/KDIGO_2012_CKD_GL.pdf

Kirsztajn, G.M., Salgado Filho, N., Draibe, SA, Netto, MVP, Thome, FS, Souza, E., e Bastos, MG (2014). Leitura rápida do KDIGO 2012: Diretrizes para avaliação e manuseio da doença renal crônica na prática clínica. Brazilian Journal of Nephrology, 36(1), 63-73. http://dx.doi.org/10.5935/0101-2800.20140012

Lau, KK, Obeid, J., Breithaupt, P., Belostotsky, V., Arora, S., Nguyen, T., e Timmons, BW (2015). Effects of acute exercise on markers of inflammation in pediatric chronic kidney disease: a pilot study. Pediatr Nephrol. 30(4), 615-21. https://doi.org/10.1007/s00467-014-2971-8

Levey, A.S., Bosch, J.P., Lewis, J.B., Greene, T., Rogers, N., e Roth, D. (1999). A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Annals of Internal Medicine, 130(6), 461-470. https://doi.org/10.7326/0003-4819-130-6-199903160-00002

Levey, A.S., Stevens, L.A., e Schmid, C.H. (2009). A new equation to estimate glomerular filtration rate. Annals of Internal Medicine, 150(9), 604-612. https://doi.org/10.7326/0003-4819-150-9-200905050-00006

Lin, CH, Hsu, YJ, Hsu, PH, Lee, YL, Lin, CH, Lee, MS, e Chiang, SL (2021). Effects of Intradialytic Exercise on Dialytic Parameters, Health-Related Quality of Life, and Depression Status in Hemodialysis Patients: A Randomized Controlled Trial. International Journal Of Environmental Research And Public Health. 18(17), 9205, 2021. https://doi.org/10.3390/ijerph18179205

Martin, N., Smith, A.C., Dungey, M.R., Young, H.M.L., Burton, J.O., e Bishop, N.C. (2018). Exercise during hemodialysis does not affect the phenotype or prothrombotic nature of microparticles but alter their proinflammatory function. Physiol Rep., 6(19), e13825. https://doi.org/10.14814/phy2.13825

Monteiro, D., Martins, C., Santos, N., Infante, M., Carrapato, PMC, Pires, M., Almeida, E., e Correia, PMAR (2018). O exercício físico e a hemodiálise - relação entre um programa regular de exercício físico intradialítico e a capacidade funcional dos doentes em programa regular de hemodiálise. Journal of Aging & Innovation, 7(3), 10-129. http://journalofagingandinnovation.org/wp-content/uploads/13JAIV7E3.pdf

Oh-Park, M., Fast, A., Gopal, S., Lynn, R., Frei, G., Drenth, R., e Zohman, L. (2002). Exercise for the dialyzed: Aerobic and strength training during hemodialysis. Am J Phys Med Rehabil., 81(11), 814-821. https://doi.org/10.1097/00002060-200211000-00003

Ribeiro, R., Coutinho, GL, Iuras, A., Barbosa, AM, Souza, JAC, Diniz, DP, Schor, N. (2013). Efeito do exercício resistido intradialítico em pacientes renais crônicos em hemodiálise. J. Bras. Nefrol., 35(1), 13-19. https://doi.org/10.5935/01012800.20130003

Riella, M.C., e Martins, C. (2013). Nutrição e o Rim (2ª ed.). Editora Guanabara Koogan.

Santana, D.A., Poortmans, JR, Dórea, EL, Machado, JBA, Fernandes, AL, Sá-Pinto, AL, Gualano, B., e Roschel, H. (2017). Acute exercise does not impair renal function inn nondialysis chronic kidney disease patients regardless of disease stage. Am J Physiol Renal Physiol., 313(2), p. 547-552. https://doi.org/10.1152/ajprenal.00131.2017

Sociedade Brasileira de Nefrologia - SBN (2018). Censo 2017, 25, 114. https://arquivos.sbn.org.br/uploads/sbninforma114.pdf

Terra, F.S., Costa, A.M.D.D., Figueiredo, E.T. de, Morais, A.M. de, Costa, M.D., e Costa, R.D. (2010). As principais complicações apresentadas pelos pacientes renais crônicos durante as sessões de hemodiálise. Revista da Sociedade Brasileira de Clínica Médica, 8(3), 187-92. https://pesquisa.bvsalud.org/portal/resource/pt/lil-549749

Song, W., e Sohng, K. (2012). Effects of progressive resistance training on body composition, physical fitness and quality of life of patients on hemodialysis. Journal of Korean Academy of Nursing, 42(7), 947-956. https://doi.org/10.4040/jkan.2012.42.7.947

Torino, C., Manfredini, F., Bolignano, D., Aucella, F, Baggetta, R., Barillà, A. Battaglia, Y., Bertoli, S., Bonanno, G., Castellino, P., Ciurlino, D., Cupisti, A., D'Arrigo, G., De Paola, L., Fabrizi, F., Fatuzzo, P., Fuiano, G., Lombardi L., Lucisano, G., Messa, P., Rapanà, R., Rapisarda, F., Rastelli, S., Rocca-Rey, L., Summaria, C., Zuccalà, A., Tripepi, G., Catizone, L., Zoccali, C., Mallamaci, F., e EXCITE Working Group (2014). Physical performance and clinical outcomes in dialysis patients: a secondary analysis of the EXCITE trial. Kidney Blood Press Res., 39(2-3), 205-211. https://doi.org/10.1159/000355798

Uchoa , MR, Magalhães, ALO, Bronzo, T., Brito, MMP, Araújo, LFC, Costa, MB, Silva, ER, Lima, GSC, Silva, FSS, Lima, GBB, Costa, SS, e Amorim, CEN (2021). The efficiency and safety in the implementation of physical exercise protocols as a non-drug treatment for chronic renal patients on hemodialysis and the difficulties of implementation in clinical practice: an integrative review. Research, Society and Development. 10(17), 1-13. https://doi.org/10.33448/rsd-v10i17.24406

Van Craenenbroeck, AH, Ledeganck, KJ, Van Ackeren, K., Jürgens, A., Hoymans, VY, Fransen, E., Adams, V., De Winter, BY, Verpooten, GA, Vrints, CJ, Couttenye, MM, e Van Craenenbroeck, EM (2015). Plasma levels of microRNA in chronic kidney disease: patterns in acute and chronic exercise. Am J Physiol Heart Circ Physiol., 309, H2008-H2016. https://doi.org/10.1152/ajpheart.00346.2015

Viana, JL, Kosmadakis, G., Watson, EL, Bevington, A., Feehally, J., Bishop, J., e Smith, AC (2014). Evidence for anti-inflammatory effects of exercise in CKD. J Am Soc Nephrol., 25, 2121-2130. https://doi.org/10.1681/ASN.2013070702

Zhang, F., Huang, L, Wang, W., e Shen, Q. (2020). Effect of intradialytic progressive resistance exercise on physical fitness and quality of life in maintenance haemodialysis patients. Nursing Open, 7(6), 1945-1953. http://dx.doi.org/10.1002/nop2.585

Biografía del autor/a

Alisson Miguel Knob,

http://lattes.cnpq.br/6337179629240289

Mayara Teodoro Jacob Oliveira Freitag,

http://lattes.cnpq.br/6790267499208265

Abel Felipe Freitag,

http://lattes.cnpq.br/1284071982697707

Publicado
2023-02-12
Cómo citar
Knob, A. M., Freitag, M. T. J. O., & Freitag, A. F. (2023). El efecto de una sesión de entrenamiento en pacientes con enfermedad renal crónica: Una revisión sistemática. Lecturas: Educación Física Y Deportes, 27(297), 201-214. https://doi.org/10.46642/efd.v27i297.3497
Sección
Artículos de Revisión