Assessment of physical performance and quality of life before and after correction of anemia and malnutrition in hemodialysis patients

Abstract EN

Background Patients treated by hemodialysis (HD) have a dramatically impaired physical working capacity, which reduces the patient’s quality of life. Aim : this study aimed to assess the effect of exercise training, correction of anemia and malnutrition on physical performance and quality of life in HD patients.

The study was carried on forty chronic renal failure (CRF) patients on maintenance HD for more than two years divided in two groups, group 1 patients were involved in a 12 weeks exercise program and group 2 patients were not involved in any specific exercise program as controls. Methods : All patients were subjected to –Detailed :- history and full clinical examination with stress on measuring mean pre dialysis and post dialysis blood pressure, anthropometric measures (body mass index, triceps skin fold, thigh skin fold, suprailiac skin fold, abdominal skin fold and chest skin fold) and calculation of percentage body fat (%BF).

Assessment of health related quality of life (HRQOL) using kidney disease quality of Life, short form questionnaire.

Laboratory investigations including serum albumin, calculation of normalized protein catabolic rate (NPCR) and Kt / V and complete blood count (CBC).Measurement of physical working capacity PWC.

Patients of group 1 were involved in an exercise-training program on an electronically beaked bicycle ergometer for 12 weeks.

Correction of anemia and malnutrition for both groups. Results: The study demonstrated a significant decrease in the mean pre-dialysis and post-dialysis blood pressure in group 1 (P<0.01), a significant increase in anthropometric measures and %BF in group 1 and group 2 (P<0.01).

A significant increase in the total score of HR-QOL of group 1and 2.

The total score was significantly higher in group 1 than 2 (P<0.01).

A significant increase in serum albumin in group 1 and 2 (P<0.01).

A significant increase in the hemoglobin and hematocrit level in group 1 and 2 (P<0.01).

A significant increase of PWC and the training session duration in group 1 (P<0.01).

PWC had positive correlations with serum albumin (r = 0.439, P<0.01) and the total score of the HR-QOL questionnaire (r= 0.600, P<0.01) Conclusion: We concluded that the appropriate application of an exercise program, correction of anemia and malnutrition would improve the quality of life and increase the work capacity in maintenance HD patients.