OBJECTIVE:To assess the association of residual diuresis with sarcopenia in patients with Chronic Kidney Disease (CKD) on hemodialysis.METHODS:Through a cross-sectional study, patients on hemodialysis were subjected t...
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OBJECTIVE:To assess the association of residual diuresis with sarcopenia in patients with Chronic Kidney Disease (CKD) on hemodialysis.
METHODS:Through a cross-sectional study, patients on hemodialysis were subjected to a Dual Energy Radiologic Absorption (DEXA) exam to record muscle mass. Based on the volume of urine collected in 24 hours, patients were classified as anuric (diuresis ≤ 100 mL/day) or non-anuric (diuresis > 100 mL/day). functionalperformance was evaluated by Short Physical performance Battery (SPPB) and muscle strength by handgrip strength and 5-repetition sit-to-stand test. The association between the absence of residual urine and the presence of sarcopenia, low SPPB, and low muscle strength was analyzed using a binary logistic regression model.
RESULTS:Ninety-two patients, with a mean age of 54.4 years (95% CI 51.3 - 57.4) and with a mean diuresis volume of 476.3 mL/day (95% CI 320.4 - 632.2) were evaluated (48 anuric and 44 non-anuric). Anuric patients had a 2.77 (95% CI 1.14 - 6.73) times greater probability of sarcopenia and had a 3.55 (1.14 - 11.0) times greater probability of low SPPB, regardless of gender, age, and time on dialysis. Gender was the other associated variable for the presence of sarcopenia, with males having a 3.30 (95% CI 1.34 - 8.13) times higher risk. There were no associations with muscle strength.
CONCLUSION:The absence of residual diuresis in patients on hemodialysis is associated with a higher risk of sarcopenia and low functionalperformance.
BackgroundTranscutaneous electrical stimulation (ES) is a therapeutic procedure used in rehabilitation. However, the effectiveness of it depends on sensory responses to pain and motor control in neuromuscular recruitm...
BackgroundTranscutaneous electrical stimulation (ES) is a therapeutic procedure used in rehabilitation. However, the effectiveness of it depends on sensory responses to pain and motor control in neuromuscular recruitment, considering the differences related to gender and age of the subjects treated, as well as the intensity and frequency of ES. ObjectiveTo determine the threshold of sensory perception (TSP) and the threshold of motor response (TMR) in young and elderly individuals of both genders. DesignRandomized controlled clinical trial. SettingGeneral community. ParticipantsEighty volunteers with no history of systemic diseases were selected to participate in the study: 40 men and 40 women were subdivided by convenience sampling and age group into young male and female (age 21.6 ± 2.4 years) groups as well as into elderly female and male groups (age 72.6 ± 6.1 years). InterventionsThe participants received electrical stimulation (ES) at 5 and 50 Hz, with pulse durations of 20, 100, 400, 1000, and 3000 μs applied on the flexor muscle bellies of the wrist and fingers. Main Outcome MeasuresTSP was identified as the first sensation of increased current intensity and TMR as the minimum musclecontraction detected. The results weresubmitted to analysis of variance, followed by the Tukey's test, with a significance level of 5%. ResultsTSP was lower than TMR for all pulse durations, regardless of gender and age. In women, TSP was lower than that in young and elderly men at both frequencies. However, TSP was higher in elderly subjects than in younger subjects at 50 Hz for both genders. Age also affected the TMR, presenting higher thresholds in elderly subjects of both genders at 50 Hz; however the same occurred only in male subjects at 5 Hz. ConclusionAge and gender interfere directly with ES. These variables should be considered during rehabilitation because they indicate that electrical stimulation in elderly women should be carefully performed, as
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