El ejercicio físico y el paciente renal crónico

Abstract

In recent years we have witnessed rapid and continuous technological development in haemodialysis (HD) therapies. This fact produces the consequent increase in life expectancy of patients with end-stage renal disease, increasing survival and improving the relief of uremic symptoms. However, the weakness suffered by these patients is well known; it is the cause of a tendency to lead a sedentary lifestyle, despite studies that report that exercise during HD is safe even in elderly patients with multiple comorbidities1. For this reason, one of the pillars of care we should provide to these patients should be focused on providing greater support in the rehabilitation process². This lack of physical activity contributes significantly to increased mortality from cardiovascular causes, favouring the development and progression of chronic diseases such as heart disease, hypertension and diabetes³. For this reason, as early as the beginning of the 1980s, countries such as the United States began to implement physical exercise programmes during HD. Since then, many studies refer to the benefits of exercise on a physiological, functional or psychological level4. Several studies even indicate that exercise could improve the adequacy of dialysis^5-8 and increase the long-term survival rate⁹. However, although Spanish nephrological nursing has taken an interest in the subject in different forums, there is still a shortage of research in Spain that implements physical exercise programmes exclusively for HD patients⁴. However, the Spanish Society of Nephrological Nursing has echoed this issue by complementing the evidence published so far through reviews and scientific articles^10,11.