A fadiga está associada à capacidade funcional, força muscular e sarcopenia em adultos com doença renal crônica dialítica?

Abstract

Introduction: Patients with dialytic chronic kidney disease (CKD) experience negative impacts on their functionality, leading to signs and symptoms such as fatigue, reduced functional capacity, and sarcopenia. Despite its relevance, fatigue is not routinely measured in clinical practice, and studies on patients' fatigue experience investigate it in a limited and fragmented manner. Objectives: 1) To evaluate the sensation of fatigue, functional capacity, muscle strength, and risk of sarcopenia in people with CKD on hemodialysis; 2) to compare the above outcomes, as well as clinical and laboratory outcomes, between participants who report a sensation of fatigue and those who do not; 3) to verify the relationship between functional capacity, muscle strength, and sarcopenia risk with the sensation of fatigue. Method: This was a cross-sectional, descriptive, and analytical study conducted in the hemodialysis sector of Hospital Universitário Getúlio Vargas, at Manaus, Amazonas. Individuals with dialytic CKD underwent evaluation of fatigue sensation (Fatigue Severity Scale [FSS]), functional capacity (1-Minute Sit-to-Stand Test), handgrip strength (handgrip strength test), and sarcopenia risk (SARC-CalF). Clinical and laboratory data related to kidney disease were also recorded. Results: 12 individuals with dialytic CKD were included. They were divided into two groups: with fatigue (n=12, 4 men, 43±14.5 years, BMI 24.7±3.4 Kg/m2) and without fatigue (n=12, 5 men, 44.3±15.4 years, BMI 23.8±4.5 Kg/m2). There was no difference between the groups in any of the investigated outcomes (p>0.05 for all). There was a correlation between FSS score and age (r=0.47), Kt/V (r=0.63), handgrip strength (r=-0.44), phosphorus (r=-0.55), post-dialysis urea (r=-0.43), and hemoglobin (r=-0.44). Conclusions: Dialytic chronic kidney disease patients with and without perceived fatigue present similar functional capacity, peripheral muscle strength, and sarcopenia risk. This suggests that the sensation of fatigue may be associated with multiple factors, with physical capacity not being an isolated determinant. Biochemical variables also do not differ between groups. There is a tendency for higher FSS scores with increasing age and higher Kt/V. In constrast, the greater the muscle strength, phosphorus levels, and hemoglobin concentration, the lower the FSS scores. Higher concentrations of red blood cell components were also associated with lower fatigue scores.