Physical performance of patients with chronic kidney disease stage 5D and coronary heart disease

Abstract

   BACKGROUND. Assessment of physical performance in patients is usually based on the results of the 6-minute walk test, which is primarily associated with heart or respiratory failure.   THE AIM: to analyze the results of the 6-minute walk test with clinical and laboratory parameters of patients with CKD 5D, including criteria for protein-energy malnutrition.   PATIENTS AND METHODS. 67 people with CKD 5D were examined, including 42 men and 25 women, mean age 49.0 ± 14.9 and 57.2 ± 15.5 years, respectively, p = 0.036. The duration of RRT in men was 96.1 ± 80.3 months, in women 100.7 ± 66.1 months, p = 0.810. The diagnosis of coronary heart disease was established in 22 people, 7 of them had AMI. The muscle strength of the skeletal muscles was assessed using a hand dynamometer, the performance of the skeletal muscles – during a test with a 6-minute walk. All patients filled out food diaries, where they indicated the qualitative and quantitative composition of the food which they consumed for 3 days.   RESULTS. Walking load was most easily tolerated by patients without clinical manifestations of CAD. Between patients with and without AMI in history, the number of points on the Borg scale was comparable and reached the maximum values. The highest concentration of C-reactive protein and the lowest concentration of serum albumin were observed in patients who had had AMI. Relationships were found between serum albumin with C-reactive protein and the results of the 6-minute walk test, as well as between the mass index of the left ventricular myocardium with the results of the 6-minute walk test.   CONCLUSION. Left ventricular hypertrophy masks the clinical signs of reduced physical performance, but increases the risk of cardiovascular complications. The results of the 6-minute walk test in patients with CAD should be evaluated in more detail. A number of studies are needed to clarify how dietary recommendations should be modified depending on the level of systemic inflammation in CKD.