Evaluation of Functional Capacity and Rate of Perceived Exertion through Six-minute Walk Test in Pre and Post-haemodialysis Patients with Chronic Kidney Disease: A Prospective Cohort Study

Abstract

Introduction: Chronic Kidney Disease (CKD) is a condition that affects multiple organs, including the respiratory system. Haemodialysis is a commonly used treatment for End-stage Renal Disease (ESRD), but it can lead to respiratory issues, reduced muscle strength, decreased functional capacity, and lower quality of life. The Six-minute Walk Test (6MWT) is widely accepted for assessing functional capacity in CKD patients. Aim: To evaluate the impact of haemodialysis on the functional capacity and Rate of Perceived Exertion (RPE) in patients with CKD by employing the 6MWT as a comprehensive measure. Materials and Methods: A prospective cohort study was conducted in the Department of Nephrology and Dialysis ward at MGM Hospital, Aurangabad, Maharashtra, India, from April 2020 to December 2021. A total of 73 patients were included in the present study. The primary outcome measure was the walked distance assessed using the 6MWT, and secondary outcomes are the RPE were evaluated using the Modified Borg Scale (MBS). Gait speed was also measured. Baseline demographic data, laboratory investigations, and associated co-morbidities were collected. The tests were performed before and immediately after the haemodialysis session. Data were analysed using the Student’s t-test and one-way Analysis of Variance (ANOVA), and the statistical significance level was setup at p<0.05. Results: The mean age of the study participants was 44±8.25 years. The study found a significant reduction in walking distance (mean of 85 meters) after the haemodialysis session compared to the pre-session. The post-haemodialysis session showed a significant increase in RPE and fatigue levels (p=0.0001). Additionally, a significant difference in gait speed (p=0.0001) was observed between the pre and post-haemodialysis sessions. Conclusion: The present study findings indicate a significant decrease in walking distance and noteworthy increase in RPE and fatigue levels following haemodialysis sessions in CKD patients. These results emphasise the impact of haemodialysis on functional capacity and perceived exertion among individuals with this condition.