MO593: Study of Cardiopulmonal Parameters in Patients with CKD During Renal Rehabilitation

Abstract

Abstract BACKGROUND AND AIMS Chronic kidney disease is a global health problem in which patients’ performance decreases as renal dysfunction progresses. However, no evidence-based lifestyle recommendations for the primary prevention of CKD have yet been developed. The aim of the study was to study cardiorespiratory parameters in patients with CKD during aerobic exercise of light and moderate intensity. METHOD The study included 130 patients with CKD stages 2–3, aged 45– 65 years, whose average age was 58.7 ± 0.73 years, and the proportion of women in the sample was 47.7%. All patients underwent determination of urea, serum creatinine, measurement of blood pressure and heart rate. To determine exercise tolerance, a cardiorespiratory exercise test was performed. Patients of the main group, depending on the initial cardiorespiratory parameters, were divided into 2 subgroups: 1 subgroup—67 patients who performed light intensity exercises; 2 subgroups—33 patients who performed medium-intensity exercises for 12 weeks 3 times a week. The choice of training intensity was made according to the level of individual or subjective perception of the load and was calculated using the approximate heart rate. The control group consisted of patients with CKD stages 2–3 who did not perform physical training. RESULTS When studying the indicators of systolic and diastolic blood pressure before and after physical training, moderately severe arterial hypertension was revealed. After 12 weeks of physical training in the group with medium-intensity training in patients, the blood pressure level significantly decreased compared with the baseline values ​​(SBP from 147 mm Hg to 129 mm Hg, DBP from 99 mm Hg) up to 79 mm Hg, P < 0.001), while in the group with physical training of light intensity this indicator practically did not change (SBP decreased from 147 to 138 mm Hg, DBP 93 to 89 mm Hg, respectively). A hypertensive reaction to physical activity was also confirmed, with positive dynamics at the stages of physical rehabilitation. After 12 weeks, except for the VO2 in VT, the HR in VT and the RCP, all other cardiopulmonary parameters increased in the main group (P < 0.05). The maximum oxygen consumption in the study group before the start of training peak VO2 (mL/kg/min) was 22.8 ± 0.3 after training 26.1 ± 0.4 (P < 0.05). In the control group, it was 23.6 ± 0.8 and 24.2 ± 0.7, respectively. In addition, the dynamics of the indicator of maximum oxygen consumption VO2 peak in the main group was significantly higher compared with the control group and with the baseline values(P < 0.001). CONCLUSION Training intensity is essential for improving cardiorespiratory parameters in patients with CKD. When choosing the intensity of training, it is necessary to take into account the baseline cardiorespiratory parameters. The use of physical training in combination with standard therapy improves cardiorespiratory parameters in patients with CKD.