Atividade física, qualidade de vida e perfil nutricional em pacientes renais crônicos em tratamento conservador

Abstract

INTRODUCTION: Chronic Kidney Disease (CKD) is a sustained damage to the renal parenchyma causing deterioration and progressive loss of kidney function that can progress to the end stage. Some studies have shown beneficial results for the practice of physical exercise in adjuvant treatment for metabolic diseases such as obesity, dyslipidemia and diabetes mellitus; and for cardiovascular diseases and systemic arterial hypertension, pathologies that are bases or metabolic alterations associated with the development of CKD. Such benefits can also be observed in aspects of quality of life. OBJECTIVE: To associate the level of physical activity, quality of life and nutritional profile in patients undergoing conservative treatment for Chronic Kidney Disease in a tertiary care hospital in the northeastern region of Brazil. MATERIALS AND METHODS: Cross-sectional observational study. The sample was selected for convenience and consisted of patients undergoing conservative treatment for CKD with GFR <89 mL/min/1.73m2 . People of both sexes were included; aged over 18 years; who signed the Free and Informed Consent Term (ICF). The social profile (gender, housing, marital status and education), health (pre-existing diseases, alcohol consumption and tobacco) and nutritional profile (weight, height, body mass index (BMI), waist circumference (WC) were evaluated. and fat percentage (calculated from the triceps, subscapular and suprailiac skinfolds), physical activity level (IPAQ), quality of life level (WHOQOL-Bref). JASP statistical package version 0.13.1, reaching a confidence level of 95% (p<0.05) RESULTS: Two articles were produced in this dissertation. In article 1 the objective was to associate the stages of CKD with the level of physical activity , quality of life and nutritional profile, and the results were: 52 patients with a mean age of 60.3 ± 9.11 years, 53.84% women, 61% with less than nine years of schooling, 57.69% diabetics Type 2 and 76.92% hypertensive; for the nutritional profile and level of physical activity, 38.46 % were obese and 61.53% eutrophic or overweight; 82.69% with high CC standards; and 67% had low levels of physical activity; in relation to the level of quality of life, lower scores in satisfaction with health (2.98± 0.83) and environment (2.75± 0.38); better scores in the psychological domain (3.80±0.53) and social relationships (3.58±0.58), the sample showed regular levels of quality of life; There was no significant association between study variables and stratification of patients in glomerular filtration levels; The correlation was positive for the CKD stage with the social relationships dimension of the level of quality of life (r=0.247, p=0.07, 95% CI 0.7, 0.4), but the Other variables showed negative correlations. In article 2, the objective was to associate the level of physical activity of CKD patients undergoing conservative treatment with the nutritional profile and the perception of quality of life and the results were: 70 patients with a mean age of 60.5 ± 9.57 years, 57 .14% women, 52.85% diabetics and 80% hypertensive; for the nutritional profile, the sample presented obesity in most of the population (55.71%), high WC rates (95.04± 16.9 cm); and 67.15% had low levels of physical activity, with the highest average in domestic physical activities (32.23 min/week); for the level of quality of life, lower scores in satisfaction with health (2.85± 1.53) and environment (2.73± 0.49); better scores in the psychological domain (3.73±0.69) and social relationships (3.64±0.73); the physically active group presented lower values of weight, BMI and WC than the groups with low physical activity, p=0.028, p=0.043 and p=0.039 respectively. The level of physical activity was positively correlated with the glomerular filtration rate variables; fat percentage; fat mass; physical dimensions, general health perception and general health satisfaction and quality of life; and with all dimensions of physical activity (work, commuting, domestic and leisure), r=0.190, r=0.004, r=0.442, r=0.212, r=0.125, r=0.125, r=0.947, r=0.442, r=0.674, r=0.564 respectively. CONCLUSION: The subjects presented low levels of physical activity and a high percentage of overweight/obesity, but these levels did not change in association with the stages of CKD. Although CKD is an inflammatory, chronic and progressive disease, with current pharmacological therapies proving to be limited in controlling its evolution, the study showed that physical activity presents a positive response in the control of parameters that contribute to its advancement, being a way to multiprofessional care for the disease.