P0961PHYSICAL REHABILITATION OF PATIENTS WITH CHRONIC KIDNEY DISEASE OF PRE -DIALYSIS STAGES

Abstract

Background and Aims: Chronic kidney disease is a global public health problem. Poor physical condition and skeletal muscle depletion are associated with the combined effects of uremic acidosis, protein-energy deficiency and inflammatory depletion, which leads to further exacerbation of a sedentary lifestyle. The aim of the determination of physical performance and the effectiveness of physical training during the 12-week program in patients with CKD of pre-dialysis stages. Method: We examined 130 patients with CKD 2-4 stages. Clinical parameters (BP, BMI, mid-thigh circumference, mid-shoulder circumference, mid-calf circumference), laboratory data (serum creatinine, serum cholesterol, serum albumin, serum phosphorus, serum calcium) were evaluated in all patients according to the formula CKD-EPI 2011. Physical performance was determined by the results of cardiopulmonary stress test. In accordance with the initial data of the patients, a 12-week physical rehabilitation program was individually selected, which included morning exercises, physiotherapy exercises and dosed walking . The data obtained were subjected to statistical processing. Results: The average age of patients was 54.8 years. Of these, 52 women (40%) and 78 (60%) men. The estimated glomerular filtration rate varied from 30 to 60 ml / min / 1.73 m2, which corresponded to the indicators of the pre-dialysis stages of CKD. After a 12-week rehabilitation program, the maximal oxygen consumption (V O2peak) increased in 70% of regularly engaged patients by 1.2 times (22.31 ml / min / kg and 27.05 ml / min / kg, respectively), and in 30% of those who did not pass the course Exercise therapy, the indicator of maximum oxygen consumption after 12 weeks was 21.7 ml / min / kg (with an initial 23.7ml / min / kg) The average blood pressure decreased slightly (from 111±5 initially to 106±5mmHg after 12 weeks, p<0.05) When measuring anthropometric parameters, it was found that the circle the mid-thigh increased from 46.5±6.0 cm to 0.6 cm, the circumference of the middle of the shoulder increased from 31.1±4.0 cm to 0.4 cm. The circumference of the middle part of the lower leg was initially 356.7±3.8 cm, and after 12 weeks of training it increased 0.3 cm. In 9 patients, these parameters did not change after a 12-week program. Conclusion: Regular physical training led to an increase in the maximum oxygen consumption by 1.2 times. It was noted that regular training contributes to a slight increase in muscle mass in patients with CKD. The importance of regularity of physical therapy classes was also revealed.