Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFS |
Texto Completo: | https://ri.ufs.br/jspui/handle/riufs/14909 |
Resumo: | Chronic kidney disease is characterized by progressive damage to renal function diagnosed through reduction of glomerular filtration rate, albuminuria, and creatinine, which, due to health problems, lead to the need for renal replacement therapy, with hemodialysis being the most common method. used. Disease progression may be associated with decreased functional capacity and dysfunction of cardiovascular autonomic control. In view of this, this study aimed to investigate the functional evaluation instruments and cardiovascular autonomic function of chronic renal patients submitted to hemodialysis. The study was divided in two parts: a systematic review of randomized clinical trials on functional evaluation with protocol elaborated and registered in PROSPERO with the number CRD42018099908, following recommendations PRISMA and Cochrane, with search carried out in PubMed, LILACS and PeDro databases and search manual, updated in November 2018. The search resulted in 2085 records, of which 25 met the inclusion criteria. The studies were published between 2000 and 2018, with the combined intervention (aerobic and resisted exercises) being used in most of the studies, and the most commonly used sit-to-stand, 6-min walk, KDQOL-SF and Timed Up and Go. The second part is a cross-sectional observational study performed at a hemodialysis clinic, approved by CEP-UFS under no. of opinion 2,594,848. The sample consisted of 58 volunteers divided into two hemodialytic (HD) (n = 29) and healthy (CO) (n = 29) groups, paired by age, gender and body mass index. Heart frequency (HR), heart rate variability (HRV) and autonomic challenges (Cold Pressor (CP) and Deep Breath (DB)) and auscultatory method for blood pressure (BP) were used. Continuous variables were expressed as mean ± standard deviation using Student's t-tests. Categorical variables used Fisher's Exact or chi-square tests for comparisons between groups. All tests considered significant p <0.05. The HD group had an increase in MBP in relation to CO during the baseline period (100.4 ± 3.0 vs 90.34 ± 1.85 mmHg; p <0.01), influenced by the difference in SBP values between the groups (139,0 ± 4,7 vs 119,1 ± 2,1 mmHg; p <0.01), however HRV did not present a significant difference. During the CP test the difference in SBP values was maintained between the groups (152.8 ± 5.9 vs. 137.1 ± 2.5 mmHg; p <0.01), although the hyperreactivity index was inversely demonstrated (p <0.01), due to the limitation of the group's physiological range HD. During the application of the DB test, a difference in ? HR can be observed (HD: 7.31 ± 0.84 vs CO: 19.62 ± 1.27 bpm; p <0.01), demonstrating the reduction of the parasympathetic response. Our results demonstrate a decrease in sympathetic and parasympathetic cardiac adjustments during autonomic challenges, demonstrating the inability of the autonomic nervous system in this population, as well as the lack of consensus regarding the instruments for the evaluation of functional capacity, performed in its largest by cardiorespiratory fitness and strength muscular. |
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Pinto, Flávio Wallace de BritoBarreto, André Sales2021-12-22T19:20:09Z2021-12-22T19:20:09Z2019-04-25PINTO, Flávio Wallace de Brito. Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise. 2019. Dissertação (Mestrado em Ciências Aplicadas à Saúde) - Universidade Federal de Sergipe, Lagarto, 2019.https://ri.ufs.br/jspui/handle/riufs/14909Chronic kidney disease is characterized by progressive damage to renal function diagnosed through reduction of glomerular filtration rate, albuminuria, and creatinine, which, due to health problems, lead to the need for renal replacement therapy, with hemodialysis being the most common method. used. Disease progression may be associated with decreased functional capacity and dysfunction of cardiovascular autonomic control. In view of this, this study aimed to investigate the functional evaluation instruments and cardiovascular autonomic function of chronic renal patients submitted to hemodialysis. The study was divided in two parts: a systematic review of randomized clinical trials on functional evaluation with protocol elaborated and registered in PROSPERO with the number CRD42018099908, following recommendations PRISMA and Cochrane, with search carried out in PubMed, LILACS and PeDro databases and search manual, updated in November 2018. The search resulted in 2085 records, of which 25 met the inclusion criteria. The studies were published between 2000 and 2018, with the combined intervention (aerobic and resisted exercises) being used in most of the studies, and the most commonly used sit-to-stand, 6-min walk, KDQOL-SF and Timed Up and Go. The second part is a cross-sectional observational study performed at a hemodialysis clinic, approved by CEP-UFS under no. of opinion 2,594,848. The sample consisted of 58 volunteers divided into two hemodialytic (HD) (n = 29) and healthy (CO) (n = 29) groups, paired by age, gender and body mass index. Heart frequency (HR), heart rate variability (HRV) and autonomic challenges (Cold Pressor (CP) and Deep Breath (DB)) and auscultatory method for blood pressure (BP) were used. Continuous variables were expressed as mean ± standard deviation using Student's t-tests. Categorical variables used Fisher's Exact or chi-square tests for comparisons between groups. All tests considered significant p <0.05. The HD group had an increase in MBP in relation to CO during the baseline period (100.4 ± 3.0 vs 90.34 ± 1.85 mmHg; p <0.01), influenced by the difference in SBP values between the groups (139,0 ± 4,7 vs 119,1 ± 2,1 mmHg; p <0.01), however HRV did not present a significant difference. During the CP test the difference in SBP values was maintained between the groups (152.8 ± 5.9 vs. 137.1 ± 2.5 mmHg; p <0.01), although the hyperreactivity index was inversely demonstrated (p <0.01), due to the limitation of the group's physiological range HD. During the application of the DB test, a difference in ? HR can be observed (HD: 7.31 ± 0.84 vs CO: 19.62 ± 1.27 bpm; p <0.01), demonstrating the reduction of the parasympathetic response. Our results demonstrate a decrease in sympathetic and parasympathetic cardiac adjustments during autonomic challenges, demonstrating the inability of the autonomic nervous system in this population, as well as the lack of consensus regarding the instruments for the evaluation of functional capacity, performed in its largest by cardiorespiratory fitness and strength muscular.A doença renal crônica é caracterizada pelo dano progressivo à função renal diagnosticada através da redução da taxa de filtração glomerular, albuminúria e aumento da creatinina, que em decorrência dos agravos à saúde, levam a necessidade de terapia renal substitutiva, sendo a hemodiálise o método mais utilizado. A progressão da doença pode estar associada à diminuição da capacidade funcional e disfunção do controle autonômico cardiovascular. Diante disto, este estudo objetivou investigar os instrumentos de avaliação funcional e função autonômica cardiovascular de pacientes renais crônicos submetidos à hemodiálise. O estudo foi dividido em duas partes: uma revisão sistemática de ensaios clínicos randomizados sobre avaliação funcional com protocolo elaborado e registrado no PROSPERO com o número CRD42018099908, seguindo recomendações PRISMA e Cochrane, com busca realizada nas bases de dados PubMed, LILACS e PeDro e literatura cinzenta, atualizada em novembro de 2018. A busca resultou em 2085 registros, dos quais 25 preencheram os critérios de inclusão. Os estudos foram publicados entre 2000 e 2018, sendo a intervenção combinada (exercícios aeróbicos e resistidos) a mais realizada, e os instrumentos de avaliação mais utilizados foram Sit-to-Stand, TC6, KDQOL-SF e Timed Up and Go. A segunda parte trata-se de estudo observacional transversal realizado em uma clínica de hemodiálise, aprovado pelo CEP-UFS com o n. do parecer 2.594.848. A amostra foi composta por 58 voluntários distribuídos em dois grupos hemodialíticos (HD) (n=29) e saudáveis (CO) (n=29), pareados por idade, gênero e índice de massa corporal. Foram utilizados cardiofrequêncimetro para aferição da Frequência Cardíaca (FC), Variabilidade da Frequência Cardíaca (VFC) e desafios autonômicos [Cold Pressor (CP) e Deep Breath (DB)] e método auscultatório para aferição da pressão arterial (PA). As variáveis contínuas foram expressas por média ± desvio padrão utilizando os testes t de Student. Variavéis categóricas utilizaram os testes Exato de Fisher ou qui-quadrado para as comparações entre os grupos. Todos os testes consideraram significativo p < 0,05. O grupo HD apresentou elevação da PAM em relação ao CO durante o período basal (de 100,4 ± 3,0 vs 90,34 ± 1,85 mmHg; p < 0,01), influenciada pela diferença dos valores da PAS entre os grupos (139,0 ± 4,7 vs 119,1 ± 2,1 mmHg; p < 0,01), contudo a VFC não apresentou diferença significativa. Durante o CP test a diferença dos valores de PAS foi mantida entre os grupos (de 152,8 ± 5,9 vs 137,1 ± 2,5 mmHg; p < 0,01), embora o índice de hiper-reatividade foi demonstrado de maneira inversa (HD: 7,31 ± 0,84 vs CO: 19,62 ± 1,27 bpm; p < 0,01), pela limitação do range fisiológico do grupo HD. Durante a aplicação do DB test pode-se observar diferença no ? FC (p < 0,01), demonstrando a redução da resposta parassimpática. Nossos resultados demonstram diminuição dos ajustes simpático e parassimpático cardíaco durante os desafios autonômicos, demonstrando a inabilidade do sistema nervoso autônomo nesta população, bem como a não existência de consenso quanto aos instrumentos de avaliação da capacidade funcional, realizada em sua maior pela aptidão cardiorrespiratória e força muscular.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESLagartoporInsuficiência renal crônicaHemodiáliseSistema cardiovascularAptidão físicaExercícioChronic renal failureHemodialysisCardiovascular systemExercise.Physical fitnessAvaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiáliseEvaluation of cardiovascular autonomic balance and instruments of functional capacity of chronic renal patients in hemodyalisis.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisPós-Graduação em Ciências Aplicadas à SaúdeUFSreponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/14909/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51ORIGINALFLÁVIO_WALLACE_BRITO_PINTO.pdfFLÁVIO_WALLACE_BRITO_PINTO.pdfapplication/pdf1623800https://ri.ufs.br/jspui/bitstream/riufs/14909/2/FL%c3%81VIO_WALLACE_BRITO_PINTO.pdf5fd3b08c0c5d06d38edde2bac4ea3b44MD52TEXTFLÁVIO_WALLACE_BRITO_PINTO.pdf.txtFLÁVIO_WALLACE_BRITO_PINTO.pdf.txtExtracted texttext/plain149004https://ri.ufs.br/jspui/bitstream/riufs/14909/3/FL%c3%81VIO_WALLACE_BRITO_PINTO.pdf.txt1cf6e3eee52de599dc18cd3aa28ed46dMD53THUMBNAILFLÁVIO_WALLACE_BRITO_PINTO.pdf.jpgFLÁVIO_WALLACE_BRITO_PINTO.pdf.jpgGenerated Thumbnailimage/jpeg1270https://ri.ufs.br/jspui/bitstream/riufs/14909/4/FL%c3%81VIO_WALLACE_BRITO_PINTO.pdf.jpg3b406cdec90e325d94008ee4a2e3be5eMD54riufs/149092021-12-22 16:20:09.713oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2021-12-22T19:20:09Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false |
dc.title.pt_BR.fl_str_mv |
Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise |
dc.title.alternative.eng.fl_str_mv |
Evaluation of cardiovascular autonomic balance and instruments of functional capacity of chronic renal patients in hemodyalisis. |
title |
Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise |
spellingShingle |
Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise Pinto, Flávio Wallace de Brito Insuficiência renal crônica Hemodiálise Sistema cardiovascular Aptidão física Exercício Chronic renal failure Hemodialysis Cardiovascular system Exercise. Physical fitness |
title_short |
Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise |
title_full |
Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise |
title_fullStr |
Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise |
title_full_unstemmed |
Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise |
title_sort |
Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise |
author |
Pinto, Flávio Wallace de Brito |
author_facet |
Pinto, Flávio Wallace de Brito |
author_role |
author |
dc.contributor.author.fl_str_mv |
Pinto, Flávio Wallace de Brito |
dc.contributor.advisor1.fl_str_mv |
Barreto, André Sales |
contributor_str_mv |
Barreto, André Sales |
dc.subject.por.fl_str_mv |
Insuficiência renal crônica Hemodiálise Sistema cardiovascular Aptidão física Exercício |
topic |
Insuficiência renal crônica Hemodiálise Sistema cardiovascular Aptidão física Exercício Chronic renal failure Hemodialysis Cardiovascular system Exercise. Physical fitness |
dc.subject.eng.fl_str_mv |
Chronic renal failure Hemodialysis Cardiovascular system Exercise. Physical fitness |
description |
Chronic kidney disease is characterized by progressive damage to renal function diagnosed through reduction of glomerular filtration rate, albuminuria, and creatinine, which, due to health problems, lead to the need for renal replacement therapy, with hemodialysis being the most common method. used. Disease progression may be associated with decreased functional capacity and dysfunction of cardiovascular autonomic control. In view of this, this study aimed to investigate the functional evaluation instruments and cardiovascular autonomic function of chronic renal patients submitted to hemodialysis. The study was divided in two parts: a systematic review of randomized clinical trials on functional evaluation with protocol elaborated and registered in PROSPERO with the number CRD42018099908, following recommendations PRISMA and Cochrane, with search carried out in PubMed, LILACS and PeDro databases and search manual, updated in November 2018. The search resulted in 2085 records, of which 25 met the inclusion criteria. The studies were published between 2000 and 2018, with the combined intervention (aerobic and resisted exercises) being used in most of the studies, and the most commonly used sit-to-stand, 6-min walk, KDQOL-SF and Timed Up and Go. The second part is a cross-sectional observational study performed at a hemodialysis clinic, approved by CEP-UFS under no. of opinion 2,594,848. The sample consisted of 58 volunteers divided into two hemodialytic (HD) (n = 29) and healthy (CO) (n = 29) groups, paired by age, gender and body mass index. Heart frequency (HR), heart rate variability (HRV) and autonomic challenges (Cold Pressor (CP) and Deep Breath (DB)) and auscultatory method for blood pressure (BP) were used. Continuous variables were expressed as mean ± standard deviation using Student's t-tests. Categorical variables used Fisher's Exact or chi-square tests for comparisons between groups. All tests considered significant p <0.05. The HD group had an increase in MBP in relation to CO during the baseline period (100.4 ± 3.0 vs 90.34 ± 1.85 mmHg; p <0.01), influenced by the difference in SBP values between the groups (139,0 ± 4,7 vs 119,1 ± 2,1 mmHg; p <0.01), however HRV did not present a significant difference. During the CP test the difference in SBP values was maintained between the groups (152.8 ± 5.9 vs. 137.1 ± 2.5 mmHg; p <0.01), although the hyperreactivity index was inversely demonstrated (p <0.01), due to the limitation of the group's physiological range HD. During the application of the DB test, a difference in ? HR can be observed (HD: 7.31 ± 0.84 vs CO: 19.62 ± 1.27 bpm; p <0.01), demonstrating the reduction of the parasympathetic response. Our results demonstrate a decrease in sympathetic and parasympathetic cardiac adjustments during autonomic challenges, demonstrating the inability of the autonomic nervous system in this population, as well as the lack of consensus regarding the instruments for the evaluation of functional capacity, performed in its largest by cardiorespiratory fitness and strength muscular. |
publishDate |
2019 |
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2019-04-25 |
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2021-12-22T19:20:09Z |
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2021-12-22T19:20:09Z |
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info:eu-repo/semantics/masterThesis |
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dc.identifier.citation.fl_str_mv |
PINTO, Flávio Wallace de Brito. Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise. 2019. Dissertação (Mestrado em Ciências Aplicadas à Saúde) - Universidade Federal de Sergipe, Lagarto, 2019. |
dc.identifier.uri.fl_str_mv |
https://ri.ufs.br/jspui/handle/riufs/14909 |
identifier_str_mv |
PINTO, Flávio Wallace de Brito. Avaliação do balanço autonômico cardiovascular e instrumentos de capacidade funcional de pacientes renais crônicos em hemodiálise. 2019. Dissertação (Mestrado em Ciências Aplicadas à Saúde) - Universidade Federal de Sergipe, Lagarto, 2019. |
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