Lo C Y, Li L, Lo W K, Chan M L, So E, Tang S, Yuen M C, Cheng I K, Chan T M
Department of Medicine, Tung Wah Hospital, Hong Kong, The People's Republic of China.
Am J Kidney Dis. 1998 Dec;32(6):1011-8. doi: 10.1016/s0272-6386(98)70076-9.
We examined the effects of a 12-week exercise program on the exercise tolerance, blood biochemistry, blood pressure (BP) control, cardiac function, and quality-of-life (QOL) scores in 13 patients undergoing continuous ambulatory peritoneal dialysis (CAPD; six men, seven women; mean age, 46.5+/-12.8 years; mean duration on dialysis, 4.8+/-3.8 years). The patients underwent exercise training on treadmill, bike, and arm ergometers thrice weekly. Seven CAPD patients matched for age, sex, and duration on dialysis served as controls. The mean peak aerobic capacity (VO2peak) of the exercisers increased by 16.2% after training (pre- and postexercise, 17.2+/-5.2 v 20.0+/-6.4 mL/kg/min; P=0.004). Although there were no significant changes in serum urea, creatinine, albumin, and hematocrit levels; left ventricular diastolic/systolic diameters; and ejection fraction, an increasing trend of high-density lipoproteins (HDLs) was observed in the exercisers (baseline v postexercise, 33+/-11 v 40+/-14 mg/dL; P=0.06). Twenty-four-hour ambulatory BP monitoring showed a significant increase in daytime systolic BP in the exercisers (pre- and postexercise, 142+/-26 v 157+/-22 mm Hg; P=0.003), but no significant changes could be found in the ambulatory daytime diastolic BP, nocturnal BP, and resting clinic BP. The patients' QOL improved after training, with better scores in two Kidney Disease Quality of Life scales (KDQOL): burden of kidney disease and physical functioning. Two mild and uncomplicated hypotensive episodes were reported in two patients immediately after training. No changes occurred in exercise capacity, blood biochemistry, BP profile, and QOL scores in the controls. We conclude that structured aerobic exercise is safe and can improve the exercise tolerance and QOL outcomes in CAPD patients.
我们研究了一项为期12周的运动计划对13例持续非卧床腹膜透析（CAPD）患者运动耐力、血液生化指标、血压（BP）控制、心脏功能和生活质量（QOL）评分的影响。这些患者中6例男性、7例女性，平均年龄46.5±12.8岁，平均透析时间4.8±3.8年。患者每周在跑步机、自行车和手臂测力计上进行3次运动训练。选取7例年龄、性别和透析时间相匹配的CAPD患者作为对照。训练后，运动组患者的平均最大有氧能力（VO2peak）提高了16.2%（运动前和运动后分别为17.2±5.2与20.0±6.4 mL/kg/min；P=0.004）。虽然血清尿素、肌酐、白蛋白和血细胞比容水平、左心室舒张/收缩直径以及射血分数没有显著变化，但运动组患者的高密度脂蛋白（HDL）有升高趋势（基线与运动后分别为33±11与40±14 mg/dL；P=0.06）。24小时动态血压监测显示，运动组患者白天收缩压显著升高（运动前和运动后分别为142±26与157±22 mmHg；P=0.003），但白天动态舒张压、夜间血压和静息诊室血压无显著变化。训练后患者的生活质量得到改善，在两个肾脏疾病生活质量量表（KDQOL）：肾脏疾病负担和身体功能方面得分更高。两名患者在训练后立即报告了两起轻微且无并发症的低血压事件。对照组患者的运动能力、血液生化指标、血压情况和生活质量评分没有变化。我们得出结论，有组织的有氧运动是安全的，并且可以改善CAPD患者的运动耐力和生活质量。
