Value of Exercise on Patients with Renal Failure - Essay Example

Physical Activities The progressive failure of kidney functions is referred to as the (CKD) chronic kidney ailment. CKD can progress to chronic renal failure at the end stage (ESRF).The primary function of kidney is to perform both regulatory and excretory processes. At this stage, the kidneys cannot perform their regulatory functions. The presence of abnormal plasma levels in multiple substances is remarkably consistent. Some of those substances include parathyroid gland and urea. These are classified as uremic toxic substances. Clinical signs of the end stage renal failure include abnormal chemistry, fluid retention and decline in the levels of hemoglobin. Renal replacement therapy can be defined as any treatment aimed at removing waste products or excess fluids from the body. This can be done through dialysis or kidney transplants. Drugs are also administered to act as supplements the functions of residual functions. It becomes imperative to have renal replacement to cater for partial or absolute kidney loss. The aim of this essay is to critically analyze the value of exercise on patients suffering from renal failure. Renal failure is associated multi-systemic dysfunction. These include abnormalities of cardiovascular and musculoskeletal systems. The conditions are also evidenced by imbalances in terms of acids and bases and psychosocial disorders. Renal failure can result from kidney infections, diabetes and endovascular diseases (Kouidi 2001). In addition, renal failure can precipitate conditions like heart failure, vascular diseases and other conditions. This calls for careful assessment of the choice of dialysis mode to the individual patients suffering from end stage renal failure. Positive clinical outcomes are dictated by the choice of effective and sustainable treatment methods (Painter & Carey 2000). This stage is composed of symptoms like generalized lethargy, neurological dysfunction, and vomiting and sleep disorder. The transition is always evidenced by symptoms of uremia. Kidney failure is associated with muscle failure. The muscle failure leads to physical impairment. Training is said to improve the quality of lives and the performance of people suffering from this condition. The actual consequence of little-power exercise is yet to be entirely acknowledged. More that 400 Americans are said to suffer from end state kidney disease. This goes a long way to maintain life (Levy& Brown 2004). The principal dialysis techniques include the ambulatory peritoneal and heamodialysis. Ambulatory peritoneal entails removing the toxins from the body through dialysis machine or an arterial kidney. This entails making use of the peritoneal cavity and implanted catheter. This aids in removing excess water and toxic substances from the body. Most of the patients who suffer from end stage renal failure are physically inactive or have minimal physical functions. According to Moore (2000), patients suffering from renal failure have a little capacity to exercise. Exercise assessment: tolerance The specific choice of the physical exercise to use depends on the primary intention of the assessment. Therefore, if the purpose of the protocol for the physical function is exercise training, and then the method shall differ from the method used for diagnostic purposes (Johansen &Soher 2003). According to Johansen & Soher (2003), the comprehensive physiological testing measures attributes like systemic blood pressure, gas exchange and cardiac functional processes. These exercises can be used to categorize patients to different groups in terms of risk factors. The lactate threshold and exercise tests are helpful in evaluating the severity or presence of renal failure symptoms (Sietsema & Amato2004). They are also useful in the establishment and determination of prognosis and impairment. When exercise assessment determines potential threatening situations and response interventions. Therefore, it is imperative to ensure or determine the safe and effective exercise intensities during rehabilitation. It is a requirement that patients should be fully acquainted with the procedures and the side effects for all the physical exercises and be in full agreement to execute the procedures. Nonetheless, exercises are complementary in nature. Exercise has a therapeutic effect on the patients suffering from renal failure. The cycle ergo meters is used as a mode of testing the exercises in the patients suffering from the end stage renal failure (Koufaki & Mercer 2002). According Koufaki & Mercer (2002), the principal advantage of this method is that monitoring both ECG and blood pressure is relatively easy. It has been observed that patients suffering from orthostatic intolerance are comfortable exercising in a seated position. However, the walking protocols are perceived to mimic the activities of daily living (Basset & Howley 2000). According to Basset & Howley (2000), this means that physical activities are effective in dealing with localized leg fatigue. Two or three minutes of unloaded exercise are necessary when used as a form of warming up by these patients (Deligiannis & Tassoulas 1999). However, small increments of about ten to fifteen watts/min-1 are viewed as necessary. This ensures the peak performance capacity by these patients. The intensity of exercise can be increased in step. According to studies, it is necessary to have longer durations for assessing the peak exercise capacity .This is achieved through peak exercise capacity protocol. The protocol has been developed over the last ten years for patients with end stage renal failure (Grassi 2000). According Grassi (2000), physiological responses should be monitored continuously and carefully. This should happen regardless of the protocol being used. The aim of this monitoring is to avoid adverse conditions during the exercises. At the same time, patients should follow and active return to non-exercising state (Koufaki &Naish 2000). This gradual return is helpful in assessing checking the assessed variables. The physicians should ensure that the cardiovascular functions go back to the pre-exercise levels (Basset & Howley 2000). Research into the levels of tolerance and outcome measures of patients with end stage renal failure is scarce. Functional independence is seen through the ability to sustain small or moderate tasks without fatigue experiences (Chertow & DaSilva 2001). A steady state is viewed through the ability to meet both sudden and increased energy production demands. According to research, if the levels of oxygen supply are inadequate to meet oxygen demand, then early fatigue is experienced. This is accompanied by delays in reaching steady state. For the renal failure patients to reach the required levels of VO2 , then constant load exercise tests are necessary (Koufaki &Naish 2000). This may include 2 minutes of periods without loads followed by further 6 minutes of loaded exercise. The sessions can be conducted interchangeably for short periods of time. According to research, squat-strength progressive muscle exercise is both beneficial in addition to safe for a haemodialysis patient. It is evident that muscle working out improves bodily performance significantly. This includes nutritional status. Studies conducted among the chronically ill indicated that strength training decreased the fat mass and the quality of life. The intra-dialectic low intensity training favors the old adults suffering from kidney failure. This is because the method is both effective and safe. Johansen &Soher (2003) argue that, there is a connection between kidney disease and cardiovascular complications. Both conditions can improve through the application of physical exercise (Chertow & DaSilva 2001). According to Chertow and DaSalva (2001), the exercise regiments are based on the duration of exercise, the frequency and intensity. However, the type of activity coupled by the level of individual fitness matter. According to studies, regular training improves the physical functioning and fitness of the adults suffering from chronic kidney disease. Some of the improvements are viewed through the capacity to walk. The beneficial effects of exercise among the patients suffering from chronic kidney disease are also visible through the impact on blood pressure. Neuromuscular exercise is important in providing the therapeutic aid needed. The mass of the muscle and its function are importance in assessing the progress of the disease in the patients (Johansen &Soher 2003). Muscle function is assessed through looking into the muscle strength. Important factors like the rate of force development, muscle relaxation and peak force are assessed through the process of exercise. Research has been conducted on the impact of exercises that touch on ankles, leg abductors and dorsiflexors. Results show that energy production in the body can increase through exercise. The patients suffering from renal end stage renal failure can easily suffer from tendon and muscle ruptures. This can happen if there are sudden changes in terms of forces (Johansen & Chertow 2000). This calls for extra causation while conduction exercises with these patients. Muscle performance assessment is feasible in most of the patients suffering from renal failure. The functional capacity assessment can substitute physical sanctions is the end stage renal failure patients. The functional capacity measures can show muscle function and mass. The most accepted functional capacity protocol for patients with renal failure is the six minutes walk assessment (Grassi 2000). Others include gait speed, sit-reach and sit-stand tests. The information on the reproducibility of the sit and stand tests are available for the patients suffering from end stage renal failure. A compelling example includes the north royal walk test. The tests entails a walk of fifty meters on a flat surface, climbing stairs, descending stairs and walking back to the point of the start. The sit- to- stand tests involve rising from a chair unassisted. At the same time, the patient is supposed to sit as fast as possible (Koufaki & Mercer 2002). The patients are instructed to keep hands crossed so that they don’t use them. The feet are supposed to remain on the ground. The test is classified into various categories. The STS-5 and STS-10 are the renown variations or categories of the test. These tests are a known to indicate the muscle power. The number of STS instances is recorded using a timer. Therefore, exercise has a tremendous therapeutic effect on the patients suffering from kidney failure. The actual measure of the peak exercise and tolerance is related to quality of life and survival. This is affects the morbidity of the patients receiving renal therapy. Clinical experts suggest that these factors should be part of the management and routine maintenance through the dialysis therapy (Gleeson & Wilcock 2002). Exercise tolerance and the functional capacity assessment for the patients suffering from end stage renal failure are considered to be both feasible and safe. Exercise for the end stage renal failure patients is good in checking the blood pressure. However, clinical advice is important when conduction resistance training (Koufaki & Mercer 2002). The aim of the exercise is to strengthen muscles through repetitions and frequency. The patients suffering from renal failure should perform six to ten exercises that target the large muscles. The exercises are crucial when it comes to controlling fluid intake and dietary factors. In order to keep the hemitropic levels around 35 per cent, it is important to conduct exercise. This goes a long way in treating anemia. Body exercise is necessary in controlling medical complications like bone diseases and diabetes (Gleeson & Wilcock 2002). Physical exercise offers therapeutic value to the patients suffering from chronic renal disease. Physical activity improves the quality of life for these patients both emotionally and physically. Chronic diseases are known to strain both the emotions and the body. Therefore, inactivity easily develops weaker muscles and low levels of activity tolerance (Deligiannis & Tassoulas 1999). This puts the patients in a vulnerable position. Studies show that urea removal and pstdyalysis are known to be occasioned by exercise (Koufaki & Mercer 2002). Research shows that cardiovascular responses are strong when exercise of intradialytic nature is conducted during the middle stages of hem dialysis. According to research, there are positive physiological benefits are registered when the exercises are conducted. Indeed, intradialytic exercises have an impact on urea kinetics (Chertow & DaSilva 2001). Exercise training among the patients with renal failure improves the exercise tolerance. This increases the physical working capacity of the patients. Exercise among these patients is known to improve the control over blood pressure besides reducing depression. Studies show that there is easier medical supervision when patients are on an exercise program. Researchers argue that exercise conducted in the late stage of hem dialysis leads to cardiovascular instability (Basset & Howley 2000). However, exercise conducted in the early stages of hemodialysis is considered to be safe and needs no modification. According to Moore (19980, physical activity should be conducted in before the last hours of the hemodialysis process. Exercise is known to increase the rate of perfusion of low-flow skeleton muscles. This facilitates the process of removal of urea and rebound reduction. There is evidence for positive impacts of regular exercise on the cardiovascular dimensions and quality of life for the people suffering from CKD. The blood pressure and heart conditions have nutritional effects on the renal disease patients. Regular exercise has an impact on the waling capacity, physical fitness and the muscle strength of the end stage renal disease patients (Beddhu & Ramkumar 2003). The design and the nature of the physical activity intervention determine the size of the effects experienced by the patients. The actual effects of resistance training and interventions of cardiovascular nature need further study. In conclusion, the chronic kidney disease is a crucial threat to the public health. Patients suffer from high costs of treatment, mortality and morbidity. This leads to low quality life and survival. Kidney complications lead to arterial hypertension and multiple risk factors. Exercise interventions are considered to be important when it comes to chronic disease patients. Patients suffering from kidney failure need physical activity. This shall reduce the risk of cardiovascular diseases. It is imperative to increase the muscle strength and reduce the depression of these patients. The physical inactivity is only important in determining the basal metabolic rate and factors that influence mortality of these patients. These strategies are vital in keeping the patients kidneys functioning. This attenuates the risks arising from the kidney related complications. Exercise or physical activity plays a crucial role in offering therapeutic value to the patients suffering from chronic kidney diseases. References Beddhu, S., Pappas, L.M., Ramkumar, N., Samore, M. 2003. Effects of body size and body composition on survival in hemodialysis patients. Journal of the American Society of Nephrology, 14,9, 2366-72. Basset D.R, E.T. Howley. 2000. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Medicine and Science in Sports and Exercise, 32,1, 70-84. Chertow, G.M., DaSilva, M., Carey, S., Painter, P. 2001. Determinants of physical performance in ambulatory patients on hemodialysis. Kidney International, 60, 1586-1591 Deligiannis, A., Kouidi E., Tassoulas, E., Gigis, P., Tourkantonis, A., Coats, A. 1999. Cardiac effects of exercise rehabilitation in hemodialysis patients. 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Physical functioning and health related quality of life changes with exercise training in haemodialysis patients. American Journal of Kidney Disease, 35,3, 482-492. Sietsema, K.E., Amato, A., Adler, S.G., Brass, E.P. 2004. Exercise capacity as a predictor of survival among ambulatory patients with end stage renal disease. Kidney International, 65, 719-724. Read More