Comparação físico funcional entre pacientes submetidos à hemodiálise e diálise peritoneal: estudo observacional transversal

• Ano de defesa: 2021
• Autor(a) principal: Haddad, Ana Carolina Pontes
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Cidade de São Paulo; Brasil; Pós-Graduação; Programa de Pós-Graduação de Mestrado em Fisioterapia; UNICID
• Palavras-chave em Português: Dinamometria manual; Doença renal crônica; Função muscular; Hemodiálise; Diálise peritoneal; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
• Link de acesso: https://repositorio.cruzeirodosul.edu.br/handle/123456789/4127

Introduction: Patients with chronic kidney disease (CKD) in the dialysis stage, both hemodialysis (HD) and peritoneal dialysis (PD), present muscle dysfunction with a decline in muscle strength in the upper (ULM) and lower (LL) limbs, resulting in limitation in the activities of daily living and negative impact on functionality and quality of life. However, HD patients experience a more restricted routine and a prolonged time of rest, which may favor sedentary behavior. Objectives: To compare peripheral muscle strength and functionality between HD patients and PD patients. Secondarily, correlate the following variables: age, peripheral muscle strength (ULM and LL), functionality and laboratory variables (Hb, Cr, Urea) and compare physical activity levels among these patients. Methodology: This is a cross-sectional observational study involving participants on hemodialysis and peritoneal dialysis for at least three months aged 18 to 75 years. They were evaluated for lower limb muscle strength by the Sit and Stand Test, hand grip strength (dynamometry) and functionality by Timed up and go (TUG). Statistical Analysis: Sample calculation according to a previous study: 49 patients in each group (HD and PD) considering the variation in upper limb strength (palm grip) as the primary variable. To establish the correlation between physical and functional tests, such as upper limb strength (dynamometer), lower limb strength (sit and stand test), functional capacity (TUG) with age, physical activity level, and laboratory data ( Hemoglobin, PTH, urea, calcium and phosphorus), Pearson's correlation test was applied. To verify the association between being physically active and being functional, the chi-square test was used. Results: 100 patients were evaluated, 50 in each group. Patients were sedentary (70%), mean of 54 (±13.6) years in both groups, median of 42 (6-204) (HD) and 19 (3-133) months of dialysis treatment. The sit and stand test presented a mean of 21.77 ± 8.38 seconds (HD) and 21.62 ±8.94 seconds (SD). The PD group showed greater hand grip strength (27.36 ±11.89 x 21.88 ±9.32 kgf and better performance in the TUG (9.86 ±4.34 x 12.25 ±2.51 seconds), age is moderately and positively correlated with lower limb strength (r=0.43 p=0.002) in the HD group and with functionality (r= 0.46, p=0.001) in patients in the PD group. Conclusion: Although these PD patients seem functionally better, there is no significant difference between them. We observed that the older the HD patients, the worse the lower limb strength and the older the PD patients, the worse the functional capacity.