Kettner-Melsheimer A, Weiss M, Huber W
Int J Artif Organs. 1987 Jan;10(1):23-30.
We studied the physical fitness of 71 patients with renal disease before dialysis, after starting dialysis, and after successful renal transplantation. Maximal muscle strength was determined in 58 patients and maximal cardiovascular capacity was assessed in 36 patients. Before dialysis there was a 31 percent reduction in muscle strength in men and 47 percent in women. The loss of muscle strength was most pronounced in the leg extensors. Cardiovascular capacity and muscle strength was positively correlated in the dialysis patients (p less than or equal to 0.05). The cardiovascular capacity was decreased 29% in predialysis patients, 45% in dialysis patients and 37% in transplanted patients compared to untrained healthy controls. The predialysis patients had a 19% greater cardiovascular capacity than the dialysis patients and a 9% greater cardiovascular capacity than the transplanted patients. While hemoglobin concentrations showed a positive correlation (p less than or equal to 0.05) with maximal cardiovascular capacity and creatinine concentration showed a negative correlation (p less than or equal to 0.05) with maximal cardiovascular capacity in the predialysis patients, hemoglobin concentrations and creatinine concentrations did not correlate with cardiovascular capacity in the dialysed and transplanted patients. In dialysis patients as well as in patients after kidney transplantation hemoglobin and creatinine concentrations, muscle strength, height, weight, and age are factors influencing the physical work capacity, but none of these variables alone seems to be a strong determination factor. Besides the complications of kidney disease which may itself reduce physical fitness, the lack of physical training is an important factor in determining the residual muscle strength and cardiovascular capacity for all patients with renal insufficiency.
我们研究了71例肾病患者在透析前、开始透析后以及成功肾移植后的体能状况。对58例患者测定了最大肌肉力量，对36例患者评估了最大心血管能力。透析前，男性肌肉力量下降31%，女性下降47%。腿部伸肌的肌肉力量损失最为明显。透析患者的心血管能力与肌肉力量呈正相关（p≤0.05）。与未经训练的健康对照组相比，透析前患者的心血管能力下降29%，透析患者下降45%，移植患者下降37%。透析前患者的心血管能力比透析患者高19%，比移植患者高9%。在透析前患者中，血红蛋白浓度与最大心血管能力呈正相关（p≤0.05），肌酐浓度与最大心血管能力呈负相关（p≤0.05），但在透析患者和移植患者中，血红蛋白浓度和肌酐浓度与心血管能力无关。在透析患者以及肾移植后患者中，血红蛋白和肌酐浓度、肌肉力量、身高、体重和年龄都是影响体力工作能力的因素，但这些变量单独看来似乎都不是一个强有力的决定因素。除了肾病本身可能会降低体能的并发症外，缺乏体育锻炼是决定所有肾功能不全患者残余肌肉力量和心血管能力的一个重要因素。
