Effect of Physical Training on Quality of Life, Functional Capacity, Pulse Wave Velocity and Biochemical Markers in Patients With Chronic Renal Failure on Conservative Treatment

The CKD is currently regarded as an important worldwide public health problem. In the United States, approximately 10.8% of population has this disease (Sarnak et al 2003) and it is estimated that by 2015 about 40 million people in this country will develop chronic renal failure (BRONAS, 2009). In Brazil, epidemiological data are rare, but there is a study that there is a prevalence of 9.6% in the population (Bastos et al, 2009).

The skeletal muscles of patients with CKD may present structural alteration and degeneration of muscle fibers, contributing to reduction of strength and endurance. The use of steroid medications, malnutrition, hormonal and electrolyte abnormalities are also other elements (CHAN, CHEEMA, SINGH, 2007). These symptoms directly contribute to physical inactivity and low mobility, increasing the risk of morbidity and mortality in patients with CKD (MANSUR LIMA; NOVAES, 2007).

To measure the quality of life of CKD patient is needed to identify how and in which dimensions of this patient's life is being affected, for such investigation SF 36 is widely used (CATTAI et al, 2007). The SF-36 assesses quality of life for the individual analysis of physical, social, emotional and mental health. (Castro et al, 2003).

There are numerous ways to assess functional capacity, and the cardiopulmonary exercise test (ET), is a valuable method for. Involves the assessment of respiratory, metabolic and cardiovascular variables by measurement of pulmonary gas exchange during exercise and expression of functional assessment indices (SIERRA, 1997; Yasbek JR, 1998). The functional capacity or aerobic capacity is determined by obtaining the contents of maximal oxygen uptake (VO2 max) and ventilatory anaerobic threshold (BARROS NETO; Tebexreni; TAMBEIRO, 2001). Several studies bounce the importance of physical activity and indicate the benefits that this can bring to patients with CKD on dialysis. Smith and colleagues (2007) submitted their dialysis patients to an exercise protocol, consisting of heating, stretching and active and resistance exercises conducted in 24 sessions. They observed a significant improvement in blood pressure (BP) and heart rate (HR), as well as improved quality of life assessed using the SF-36.

Patients with CKD have a high prevalence of cardiovascular disease (CVD) including coronary dysfunction, peripheral vascular dysfunction and heart failure (CANZIANI, 2004). The CVD represent the leading cause of death for patients in early stages of CKD, with a rate of approximately 45% in patients that do not do dialysis (Abedin et al, 2010). Recent studies have shown that markers of arterial stiffness are important predictors of mortality and morbidity related to CVD in CKD patients (MOLLER et al, 2007). The arterial stiffening is a hallmark of the aging process, due to changes in wall structure of arteries and the consequent remodeling process that can be accelerated by metabolic disturbances arising from the CKD (Frimodt-MOLLER et al, 2008; PORAZKO et al, 2009 ).