Abstract
Background and Aims
Symptoms such as fatigue, muscle weakness and impaired nutritional status are common in CKD and lead to decreased exercise tolerance.
The aim of the study was to study the effect of 12-week training on physical activity in patients with pre-dialysis stages of CKD on a low-protein diet.
Method
The study included 119 patients with CKD C3 and C4 stages. Clinical data included anthropometric data: body mass index (BMI), mid-thigh circumference and mid-shoulder circumference, laboratory data: urea, creatinine, electrolytes, albumin, total protein, hemoglobin. All patients underwent instrumental research methods: ECG, EchoCG, cardiopulmonary stress test. The patients included in the study were offered three dietary options - with a low protein content (0.6 g / kg / day;) and a limited protein content (0.6-0.8 g / kg / day;), and low protein diet with keto analogs (1 tab / 5 kg body weight / day). The physical exercise program was designed for independent home use and included cardiovascular exercises (primarily walking, morning exercises) and strength training exercises with dumbbells 1 and 3 kg. The training frequency was at least 3 times a week and had a duration of at least 20–30 minutes. The patients kept exercise diaries, which were reviewed by the doctor at each subsequent visit. The training exercise was adjusted depending on the self-perception of the patients; if necessary, the training time was increased to 60 minutes.
Results
The 1 group 24% of patients received a diet with a low protein content, the second group consisted of 40% of patients, the third group consisted of 37% of patients receiving a diet with a limited protein content. The male to female ratio, mean glomerular filtration rate, daily proteinuria and BMI did not differ significantly between groups. In the dynamics of 12 weeks of training, an increase in the mid-thigh and upper arm circumference was recorded. The study of physical activity of patients with different types of diet showed that in patients of the 1st group, even with a low nutritional status in the dynamics of 12 weeks of training, there was an improvement in such physical indicators as the circumference of the mid-thigh and upper arm, and also a slight improvement in the BMD. When comparing the groups of patients who received and did not receive ketoanologs (groups 2 and 3, respectively), physical training for 12 weeks instilled a significant improvement in indicators such as mid-arm circumference and maximum oxygen consumption(peak VO2). However, in the group receiving keto analogs, there was a significantly greater improvement in maximum oxygen consumption (peak VO2).
Conclusion
Regular dosed exercise has a positive effect on physical fitness in CKD patients on a low-protein diet. Correction of nutrition with keto analogs improves the cardiorespiratory status of patients.
Embryonic Diapause: Advances in Understanding the Enigma of Seasonal Delayed Implantation