Behavioral nutritional intervention in non-dialysis dependent Chronic Kidney Disea...
| Grant number: | 09/14786-0 |
| Support type: | Regular Research Grants |
| Duration: | February 01, 2010 - July 31, 2012 |
| Field of knowledge: | Health Sciences - Nutrition |
| Principal Investigator: | Lilian Cuppari |
| Grantee: | Lilian Cuppari |
| Home Institution: | Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil |
Abstract
Physical inactivity is an important risk factor for mortality and for the development and progression of many chronic diseases. Patients with chronic kidney disase (CKD, particularly those on dialysis therapy are shown to have a lower physical activity level when compared with healthy sedentary subjects. A number of clinical and psychological disturbances related to the disease contributes to the physical inactivity, low physical functioning and poor quality of life in these patients. In patients treated by hemodialysis studies have demonstrated a beneficial effect of regular exercise training on various metabolic parameters and particularly on physical functioning what contributes to better quality of life. Few studies, however, evaluated the impact of exercise in non-dialysis dependent CKD patients in particular when CKD is associated with obesity. Additionally, there are no studies comparing the effects of different training types on those aspects. Thus the purpose of this study is to compare the effects of a home-based aerobic training program in relation to a supervised treadmill based training on physical functioning, nutritional and cardiometabolic parameters in overweight or obese non-dialysis dependent CKD patients. A sample of 60 sedentary patients, both genders, with age between 30 and 65 years, body mass index > 25 kg/m2, on CKD stages 3 or 4. Patients with hemoglobin lower than 11g/dL, chronic obstructive pulmonary disease, cardiac failure class IV, acute myocardial infarction in the last 6 months, unstable angina, arrhythmia, uncontrolled blood pressure or uncontrolled diabetes, active infection in the last 3 weeks or with alterations in the ergometric test or yet in use of erythropoietin or beta-blockers will not be included. The patients will be randomly assigned to one of 3 groups. The patients in the group named "supervised" will train in a treadmill under supervision. The patients in the "home-based" group will be prescribed a training program to be performed at their home. The follow-up will be performed by phone calls and monthly visits. Both groups will be submitted to the training 3 times per week during 24 weeks. The "control" group will not be submitted to any type of physical exercise. All patients will be submitted to an initial evaluation and after 12 and 24 weeks including cardiorespiratory and physical functional tests, questionnaire of quality of life (SF-36), nutritional assessment, body composition (DEXA); abdominal fat (computed tomography), resting energy expenditure, echocardiogram and laboratorial tests. (AU)