Faria Ruiter de Souza, Fernandes Natália, Lovisi Júlio César Moraes, Reboredo Maycon de Moura, Marta Murilo Sérgio de Moura, Pinheiro Bruno do Valle, Bastos Marcus Gomes
Interdisciplinary Nucleus of Study, Research and Treatment in Nephrology (NIEPEN), Federal University of Juiz de Fora, José Lourenço Kelmer, 1300, São Pedro, 36036-330 Juiz de Fora, Minas Gerais, Brazil.
BMC Nephrol. 2013 Sep 4;14:184. doi: 10.1186/1471-2369-14-184.
Chronic kidney disease (CKD) involves a progressive, irreversible loss of kidney function. While early-stage CKD patients may show changes in pulmonary function and lowered exercise tolerance, the role of the estimated glomerular filtration rate (eGFR) in these patterns remains unknown. The aim of this study was to investigated pulmonary function and exercise tolerance in pre-dialytic CKD patients.
A cross-sectional study was carried out with 38 adult volunteers divided into a control group (CG), consisting of 9 healthy adults, and 29 pre-dialytic CKD patients in stages 3 (G3), 4 (G4), and 5 (G5). All participants underwent spirometric and manovacuometric tests, a cardiopulmonary exercise test (CPET), a 6-minute walk test (6MWT), and laboratory tests.
The significant differences was observed in maximal exercise tolerance, measured as peak oxygen consumption percentage (VO2peak) (mL/kg/min) (CG = 28.9 ± 7.8, G3 = 23.3 ± 5.6, G4 = 21.4 ± 5.2, G5 = 20.2 ± 6.9; p = 0.03), and submaximal exercise tolerance, measured by 6MWT (m) (CG = 627.6 ± 37.8, G3 = 577.4 ± 66.1, G4 = 542.7 ± 57.3, G5 = 531.5 ± 84.2, p = 0.01). The eGFR was associated with pulmonary function-forced expiratory volume in the first second percentage (FEV1) (%) (r = 0.34, p = 0.02) and maximum inspiratory pressure (PImax) (r = 0.41, p = 0.02) - and exercise tolerance - VO2peak (mL/kg/min) (r = 0.43, p = 0.01) and 6MWT distance (m) (r = 0.55, p < 0.01).
Pre-dialytic CKD patients showed lower maximal and submaximal exercise tolerances than healthy individuals.
慢性肾脏病（CKD）涉及肾功能进行性、不可逆丧失。虽然早期CKD患者可能出现肺功能改变和运动耐力下降，但估计肾小球滤过率（eGFR）在这些模式中的作用仍不清楚。本研究的目的是调查透析前CKD患者的肺功能和运动耐力。
对38名成年志愿者进行了一项横断面研究，分为对照组（CG），由9名健康成年人组成，以及29名3期（G3）、4期（G4）和5期（G5）的透析前CKD患者。所有参与者均接受了肺量计和压力容积测定测试、心肺运动试验（CPET）、6分钟步行试验（6MWT）以及实验室检查。
在以峰值耗氧量百分比（VO2peak）（毫升/千克/分钟）衡量的最大运动耐力方面观察到显著差异（CG = 28.9 ± 7.8，G3 = 23.3 ± 5.6, G4 = 21.4 ± 5.2, G5 = 20.2 ± 6.9；p = 0.03），以及以6MWT（米）衡量的次最大运动耐力方面（CG = 627.6 ± 37.8, G3 = 577.4 ± 66.1, G4 = 542.7 ± 57.3, G5 = 531.5 ± 84.2, p = 0.01）。eGFR与肺功能——第一秒用力呼气量百分比（FEV1）（%）（r = 0.34，p = 0.02）和最大吸气压力（PImax）（r = 0.41，p = 0.02）——以及运动耐力——VO2peak（毫升/千克/分钟）（r = 0.43，p = 0.01）和6MWT距离（米）（r = 0.55，p < 0.01）相关联。
透析前CKD患者的最大和次最大运动耐力低于健康个体。
