OBJECTIVES:The six-minute walk test has been widely used to evaluate functional capacity and predict mortality in several populations. Thus, the aim of this study was to evaluate the prognostic value of the six-minute walk test for the life expectancy of end-stage renal disease patients.METHODS:Patients over 18 years old who underwent hemodialysis for at least six months were included. Patients with hemodynamic instability, smoking, chronic obstructive pulmonary disease, physical incapacity and acute myocardial stroke in the preceding three months were excluded.RESULTS:Fifty-two patients (54% males; 36±11 years old) were followed for 144 months. The distance walked in the six-minute walk test was a survival predictor for end-stage renal disease patients. In the multivariate analysis, for each 100 meters walked with a 100-meter increment, the hazard ratio was 0.53, with a 95% confidence interval of 0.37-0.74. There was a positive correlation between the distance walked in the six-minute walk test and peak oxygen consumption (r = 0.508). In the multivariate analysis, each year of dialysis treatment represented a 10% increase in death probability; in the severity index analysis, each point on the scale represented an 11% increase in the death risk.CONCLUSIONS:We observed that survival increased approximately 5% for every 100 meters walked in the six-minute walk test, demonstrating that the test is a viable option for evaluating the functional capacity in patients with end-stage renal disease.

RESUMOObjetivo: Verificar a associação da força muscular respiratória com a capacidade funcional, força proximal de membros inferiores e variáveis bioquímicas em pacientes em hemodiálise (HD). Métodos: Participaram deste estudo 30 indivíduos (18 homens), com 53,4 ± 12,9 anos e tempo de HD de 41,1 ± 55,7 meses. Foram avaliados pressão inspiratória máxima (PImax), pressão expiratória máxima (PEmax), distância percorrida no teste de caminhada de seis minutos (6MWT), número de repetições no teste de sentar-e-levantar em 30 segundos (TSL) e registrados os exames bioquímicos de rotina no serviço. Resultados: Houve diminuição da PEmax em relação aos valores preditos (p = 0,015) e redução na distância percorrida no 6MWT quando comparados com equações de predição (p < 0,001). O logPImax e o logPEmax correlacionaram-se com o número de repetições no TSL (r = 0,476, p = 0,008; r = 0,540, p = 0,002, respectivamente), e com os níveis séricos de fósforo (r = 0,422, p = 0,020; r = 0,639, p < 0,001, respectivamente). A distância no 6MWT correlacionou-se com o logPEmax (r = 0,511; p = 0,004) e com o número de repetições no TSL (r = 0,561; p = 0,001). Conclusão: A redução da PEmax em pacientes com IRT em HD está associada à capacidade funcional, força proximal de membros inferiores e níveis de fósforo sérico, podendo representar, pelo menos em parte, o baixo desempenho físico-funcional desses pacientes.Palavras-chave: músculos respiratórios, insuficiência renal crônica, hemodiálise. ABSTRACTObjective: to evaluate the association of respiratory muscle strength with functional capacity, lower limb strength and biochemical variables in hemodialysis (HD) patients. Methods: a cross-sectional study involving 30 patients (18 male), 53.4 ± 12.9 years, 41.1 ± 55.7 months on HD therapy. Maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), distance completed in a six-minute walk test (6MWT) and number of repetitions in sit-and-stand test (STST) were evaluated. The biochemical variables were recorded in the database routine work service. Results: LogEPmax and 6MWT values were significantly lower than the predicted values (p = 0.015; p < 0.001, respectively). logPImax and logPEmax were correlated with number of repetitions in STST (r = 0.476, p = 0.008; r = 0.540, p = 0.002, respectively) and with phosphorus blood levels (r = 0.422, p = 0.020; r = 0.639, p < 0.001, respectively). 6MWT was correlated with logPEmax (r = 0.511; p = 0.004) and with number of repetitions in STST (r = 0.561; p = 0.001). Conclusion: PEmax reduction in patients with ESRD on HD is associated with functional capacity, lower limb strength and phosphorus blood levels, and may at least partly represent the low physical and functional performance of these patients.

Introduction: Obesity refers to the accumulation of fatty tissues and it favors the occurrence of oxidative stress. Alternatives that can contribute to body weight reduction have been investigated in order to reduce the production of reactive oxygen species responsible for tissue damage. The aim of the current study was to assess whether the oxidant and antioxidant markers of obese women before and after bariatric surgery were able to reduce oxidative damage. Method:We have assessed 16 morbidly obese women five days before and 180 days after the surgery. The control group comprised 16 non-obese women. Levels of thiobarbituric acid-reactive substances, carbonylated proteins, reduced glutathione and ascorbic acid were assessed in the patients' plasma. Results: Levels of lipid peroxidation and protein carbonylation in the pre-surgical obese women were higher than those of the controls and post-surgical obese women. Levels of reduced glutathione in the pre-surgical obese women were high compared to the controls, and declined after surgery. Levels of ascorbic acid fell in the pre--surgical obese women compared to the control and post-surgical obese women. Conclusion: Body weight influences the production of reactive oxygen species. Bariatric surgery, combined with weight loss and vitamin supplementation, reduces cellular oxidation, thus reducing tissue damage.

Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. . A maioria dos participantes era do sexo feminino (62,5%), tinha síndrome metabólica (61,2%), e sobrepeso/ obesidade (59%). Ao analisar a associação do estado nutricional com síndrome metabólica e seus componentes, encontrou-se associação significativa de obesidade com síndrome metabólica, obesidade central, hipertrigliceridemia, e presença de quatro/cinco componentes da síndrome (p<0,001). O componente da síndrome metabólica mais frequente foi pressão arterial elevada (81,3%) e o menos frequente foi hipertrigliceridemia (48,2%). Em relação ao sexo, a frequência de síndrome metabólica foi significativamente maior entre as mulheres (p=0,004; 66,3% versus 52,7%). Conclusões: A frequência de síndrome metabólica e seus componentes e sua associação com o estado nutricional de idosos cadastrados no HiperDia fornece indícios de que síndrome metabólica e estado nutricional também devem ser monitorados através deste sistema. DESCRITORES: síndrome X metabólica; idosos; estado nutricional; índice de massa corporal; atenção primária à saúde. ABSTRACT Aims:To analyze the association of metabolic syndrome and its components with the nutritional status of elderly enrolled in the HiperDia system. Methods: This was a cross-sectional study with a sample of elderly enrolled in the HiperDia of Central Specialty Unit of Municipal Health Department from Cruz Alta, Rio Grande do Sul, whose records contained the information necessary for the study. Metabolic syndrome diagnosis was based on criteria established by the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) and recommended by the Brazilian Society of Cardiology in the I Brazilian Guidelines for Diagnosis and Treatment of Metabolic Syndrome. Nutritional status was assessed by body mass index, according to the classification of II Guidelines on Geriatric Cardiology of the Brazilian Society of Cardiology. In the statistical analysis, the Student t test and the chi-square test were used, with analysis of adjusted residuals. Results: At all 485 seniors met the inclusion criteria and were selected. The sample mean age was 68.9±6.8 years (range 60 to 94 years). Most participants were female (62.5%) had metabolic syndrome (61.2%), and overweight/obesity (59%). When analyzing the association between nutritional status and metabolic syndrome and its components, significant associations of obesity with metabolic syndrome, central obesity, hypertriglyceridemia, and presence of four/five components of the syndrome (p <0.001) were found. The most common metabolic syndrome component was high blood pressure (81.3%), and the less frequent was hypertriglyceridemia (48.2%). Regarding gender, the frequency of metabolic syndrome was significantly higher among women (p=0.004; 66.3% versus 52.7%). Conclusions:The frequency of metabolic syndr...

No abstract