MP471EXERCISE DURING HEMODIALYSIS. A PILOT STUDY IN A SINGLE CENTER, UNIDAD RENAL SANITAS. BOGOTA COLOMBIA

Abstract

INTRODUCTION AND AIMS: Chronic kidney disease leads to multiples systemic alterations especially in patients at final stage who require dialysis. Cardiovascular and musculoskeletal affections limit their functional capacity to do outdoor activities. Our objective was to know the physical condition of hemodialysis's patients in our kidney unit and evaluate the possibilities of implementing an exercise program during dialysis. METHODS: 7 from 36 patients of the afternoon shift were chosen, age ranges between 18 to 52 years old with exclusion criteria such as cardiovascular disease, amputations, morbid obesity, and neurological conditions with limitation for walking. A “sit to stand to sit” test in 60 seconds (STS60) was performed with the assessment of vital signs (heart rate, breath, blood pressure), the Borg fatigue scale (table 1). A routine of strength, coordination, proprioception and stability exercises were prescribed with different tools like fit balls, bands and dyna -disc balance cushion in and outside therapy (table 2). The exercise plan was maintained for 10 weeks, at the end a satisfaction survey was applied to evaluate the perception of exercise on dialysis. All patients signed informed consent before evaluations. The exercise was directed and monitored by the hemodialysis physician RESULTS: All patients performed the proposed plan on dialysis and 5 of 7 patients kept doing the activities at home. The other two patients didn't exercised at home due to fatigue and they perceived the activities very hard. All patients rated the program as positive and saw it as an opportunity to improve their health because they used to associate the disease with an inability to exercise. They perceived the dialysis sessions shorter, with less anxiety and the absence of cramps by the time they were exercising CONCLUSIONS: Chronic kidney disease and dialysis itself produce significant long - term disability. Complex proinflammatory processes produces malnutrition and protein energy wasting syndrome lead significant loss of muscle mass. The implementation and adoption of an exercise plan in both dialysis and home are activities that can improve this process, also most of patients ignore the benefits of physical activities. Our study demonstrated that it is possible to perform a dialysis exercise plan with low costs, simple instruments and a high level of patient acceptance. For future research it is important to evaluate objective parameters on muscle mass gain, tolerance and adaptability to exercise and changes in functional and nutritional status (Table Presented).