Sport und Bewegungsmöglichkeiten bei älteren Dialysepatienten

ZUSAMMENFASSUNG

Alte Dialysepatienten sind in besonderem Maße durch Bewegungsmangel und Inaktivität gefährdet. Wir stellen hier sowohl den aktuellen Stand der Diskussion als auch eigene Erfahrungen mit „Sport während der Dialyse“ vor. Mit praktischen Hinweisen machen wir Vorschläge, wie ein Trainingsprogramm an der Dialyse gestaltet werden kann. Größte Hindernisse für die Umsetzung einer Dialysetrainingstherapie während der Hämodialyse sind die Unkenntnis über Wirksamkeit und Umsetzung der Trainingsprogramme sowie eine bisher noch weitgehend fehlende Finanzierung durch das Gesundheitssystem.

Publication History

Article published online:
18 May 2022

• Literatur

• 1 Halle M. Ob krank an Herz, Lunge, Niere oder bei Diabetes: Sport ist ein Grundpfeiler der Therapie. MMW Fortschr Med 2006; 148: 29
• 2 Halle M, Schmidt-Trucksäss A, Hambrecht R, Berg A. Hrsg Sporttherapie in der Medizin: evidenzbasierte Prävention und Therapie. 1. Aufl. Stuttgart. New York: Schattauer; 2008
• 3 Painter PL, Nelson-Worel JN, Hill MM. et al Effects of exercise training during hemodialysis. Nephron 1986; 43: 87-92 DOI: 10.1159/000183805.
• 4 Daul AE, Schäfers RF, Daul K. et al Exercise during hemodialysis. Clin Nephrol 2004; 61 (01) S26-S30
• 5 Deutsche Gesellschaft Rehabilitationssport für chronisch Nierenkranke e. V. Im Internet. www.reni-online.de Stand: 31.03.2022
• 6 Wong L, Duque G, McMahon LP. Sarcopenia and Frailty: Challenges in Mainstream Nephrology Practice. Kidney Int Rep 2021; 06: 2554-2564 DOI: 10.1016/j.ekir.2021.05.039.
• 7 Schulte-Kemna L, Künzig M, Dallmeier D. et al „Frailty“ bei nephrologischen Erkrankungen. Z Gerontol Geriatr 2021; 54: 708-716 DOI: 10.1007/s00391-021-01953-0.
• 8 Foote C, Kotwal S, Gallagher M. et al Survival outcomes of supportive care versus dialysis therapies for elderly patients with end-stage kidney disease: A systematic review and meta-analysis. Nephrology (Carlton) 2016; 21: 241-253 DOI: 10.1111/nep.12586.
• 9 Bechtel U, Abu-Tair M. Nierenersatzverfahren bei Hochbetagten. Nephrologe 2021: 1-7 DOI: 10.1007/s11560-021-00518-x
• 10 McAdams-DeMarco MA, Law A, Salter ML. et al Frailty as a Novel Predictor of Mortality and Hospitalization in Individuals of All Ages Undergoing Hemodialysis. J Am Geriatr Soc 2013; 61: 896-901 DOI: 10.1111/jgs.12266.
• 11 Chu NM, Chen X, Norman SP. et al Frailty Prevalence in Younger End-Stage Kidney Disease Patients Undergoing Dialysis and Transplantation. Am J Nephrol 2020; 51: 501-510 DOI: 10.1159/000508576.
• 12 Lorenz EC, Kennedy CC, Rule AD. et al Frailty in CKD and Transplantation. Kidney Int Rep 2021; 06: 2270-2280 DOI: 10.1016/j.ekir.2021.05.025.
• 13 Deutsche Gesellschaft für Nephrologie. Im Internet. www.dgfn.eu Stand: 31.03.2022
• 14 KfH Kuratorium für Dialyse und Nierentransplantation e. V. Im Internet. www.kfh.de Stand: 31.03.2022
• 15 Fried LP, Tangen CM, Walston J. et al Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56: M146-M156 DOI: 10.1093/gerona/56.3.m146.
• 16 Rampersad C, Darcel J, Harasemiw O. et al Change in Physical Activity and Function in Patients with Baseline Advanced Nondialysis CKD. Clin J Am Soc Nephrol. 2021: CJN.07050521 DOI: 10.2215/CJN.07050521
• 17 K/DOQI Workgroup K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 2005; 45: S1-S153
• 18 Bakker EA, Zoccali C, Dekker FW. et al Assessing physical activity and function in patients with chronic kidney disease: a narrative review. Clin Kidney J 2021; 14: 768-779 DOI: 10.1093/ckj/sfaa156.
• 19 Nixon AC, Bampouras TM, Pendleton N. et al Diagnostic Accuracy of Frailty Screening Methods in Advanced Chronic Kidney Disease. Nephron 2019; 141: 147-155 DOI: 10.1159/000494223.
• 20 Otobe Y, Rhee CM, Nguyen M. et al Current status of the assessment of sarcopenia, frailty, physical performance and functional status in chronic kidney disease patients. Curr Opin Nephrol Hypertens 2022; 31: 109-128 DOI: 10.1097/MNH.0000000000000763.
• 21 Torino C, Panuccio V, Tripepi R. et al The dominant prognostic value of physical functioning among quality of life domains in end-stage kidney disease. Nephrol Dial Transplant 2020; 35: 170-175 DOI: 10.1093/ndt/gfy334.
• 22 Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol 1990; 45: P239-P243 DOI: 10.1093/geronj/45.6.p239.
• 23 Zanotto T, Mercer TH, van der Linden ML. et al Screening tools to expedite assessment of frailty in people receiving haemodialysis: a diagnostic accuracy study. BMC Geriatr 2021; 21: 411 DOI: 10.1186/s12877-021-02356-x.
• 24 Isoyama N, Qureshi AR, Avesani CM. et al Comparative associations of muscle mass and muscle strength with mortality in dialysis patients. Clin J Am Soc Nephrol 2014; 09: 1720-1728 DOI: 10.2215/CJN.10261013.
• 25 Kittiskulnam P, Chertow GM, Carrero JJ. et al Sarcopenia and its individual criteria are associated, in part, with mortality among patients on hemodialysis. Kidney Int 2017; 92: 238-247 DOI: 10.1016/j.kint.2017.01.024.
• 26 Podsiadlo D, Richardson S. The timed „Up & Go“: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142-148 DOI: 10.1111/j.1532-5415.1991.tb01616.x.
• 27 Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther 2002; 82: 128-137 DOI: 10.1093/ptj/82.2.128.
• 28 Bohannon RW. Sit-to-stand test for measuring performance of lower extremity muscles. Percept Mot Skills 1995; 80: 163-166 DOI: 10.2466/pms.1995.80.1.163.
• 29 Pupim LB, Kent P, Ikizler TA. Bioelectrical impedance analysis in dialysis patients. Miner Electrolyte Metab 1999; 25: 400-406 DOI: 10.1159/000057482.
• 30 Noor H, Reid J, Slee A. Resistance exercise and nutritional interventions for augmenting sarcopenia outcomes in chronic kidney disease: a narrative review. J Cachexia Sarcopenia Muscle 2021; 12: 1621-1640 DOI: 10.1002/jcsm.12791.
• 31 Moinuddin I, Leehey DJ. A comparison of aerobic exercise and resistance training in patients with and without chronic kidney disease. Adv Chronic Kidney Dis 2008; 15: 83-96 DOI: 10.1053/j.ackd.2007.10.004.
• 32 Johansen KL, Painter P. Exercise in Individuals With CKD. Am J Kidney Dis 2012; 59: 126-134 DOI: 10.1053/j.ajkd.2011.10.008.
• 33 Smart NA, Williams AD, Levinger I. et al Exercise & Sports Science Australia (ESSA) position statement on exercise and chronic kidney disease. J Sci Med Sport 2013; 16: 406-411 DOI: 10.1016/j.jsams.2013.01.005.
• 34 Heiwe S, Jacobson SH. Exercise training in adults with CKD: a systematic review and meta-analysis. Am J Kidney Dis 2014; 64: 383-393 DOI: 10.1053/j.ajkd.2014.03.020.
• 35 Williams AD, Fassett RG, Coombes JS. Exercise in CKD: why is it important and how should it be delivered?. Am J Kidney Dis 2014; 64: 329-331 DOI: 10.1053/j.ajkd.2014.06.004.
• 36 McGuire S, Horton EJ, Renshaw D. et al Cardiac stunning during haemodialysis: the therapeutic effect of intra-dialytic exercise. Clin Kidney J 2021; 14: 1335-1344 DOI: 10.1093/ckj/sfz159.
• 37 Graham-Brown MPM, Herrington WG, Burton JO. Spinning the legs and blood: should intradialytic exercise be routinely offered during maintenance haemodialysis?. Clin Kidney J 2021; 14: 1297-1300 DOI: 10.1093/ckj/sfab018.
• 38 Kong CH, Tattersall JE, Greenwood RN. et al The effect of exercise during haemodialysis on solute removal. Nephrol Dial Transplant 1999; 14: 2927-2931 DOI: 10.1093/ndt/14.12.2927.
• 39 Vaithilingam I, Polkinghorne KR, Atkins RC. et al Time and exercise improve phosphate removal in hemodialysis patients. Am J Kidney Dis 2004; 43: 85-89 DOI: 10.1053/j.ajkd.2003.09.016.
• 40 Kirkman DL, Roberts LD, Kelm M. et al Interaction between intradialytic exercise and hemodialysis adequacy. Am J Nephrol 2013; 38: 475-482 DOI: 10.1159/000356340.
• 41 Anding K, Bär T, Trojniak-Hennig J. et al A structured exercise programme during haemodialysis for patients with chronic kidney disease: clinical benefit and long-term adherence. BMJ Open 2015; 05: e008709 DOI: 10.1136/bmjopen-2015-008709.
• 42 Kouidi E, Iacovides A, Iordanidis P. et al Exercise renal rehabilitation program: psychosocial effects. Nephron 1997; 77: 152-158 DOI: 10.1159/000190266.
• 43 Kimmel PL, Patel SS. Quality of life in patients with chronic kidney disease: focus on end-stage renal disease treated with hemodialysis. Semin Nephrol 2006; 26: 68-79 DOI: 10.1016/j.semnephrol.2005.06.015.
• 44 Finkelstein FO, Wuerth D, Finkelstein SH. An approach to addressing depression in patients with chronic kidney disease. Blood Purif 2010; 29: 121-124 DOI: 10.1159/000245637.
• 45 Ouzouni S, Kouidi E, Sioulis A. et al Effects of intradialytic exercise training on health-related quality of life indices in haemodialysis patients. Clin Rehabil 2009; 23: 53-63 DOI: 10.1177/0269215508096760.
• 46 Tentori F, Elder SJ, Thumma J. et al Physical exercise among participants in the Dialysis Outcomes and Practice Patterns Study (DOPPS): correlates and associated outcomes. Nephrol Dial Transplant 2010; 25: 3050-3062 DOI: 10.1093/ndt/gfq138.
• 47 Clyne N, Anding-Rost K. Exercise training in chronic kidney disease-effects, expectations and adherence. Clin Kidney J 2021; 14: ii3-ii14 DOI: 10.1093/ckj/sfab012.
• 48 Manfredini F, Mallamaci F, D’Arrigo G. et al Exercise in Patients on Dialysis: A Multicenter, Randomized Clinical Trial. J Am Soc Nephrol 2017; 28: 1259-1268 DOI: 10.1681/ASN.2016030378.
• 49 Kim JC, Young Do J, Kang SH. Comparisons of physical activity and understanding of the importance of exercise according to dialysis modality in maintenance dialysis patients. Sci Rep 2021; 11: 21487 DOI: 10.1038/s41598-021-00924-0.
• 50 Anding-Rost K. Sporttherapie während der Hämodialyse – Erfahrungen und Perspektiven. Spektrum der Nephrologie 2015; 28: 3-9
• 51 Hays RD, Morales LS. The RAND-36 measure of health-related quality of life. Ann Med 2001; 33: 350-357 DOI: 10.3109/07853890109002089.
• 52 Bernier-Jean A, Beruni NA, Bondonno NP. et al Exercise training for adults undergoing maintenance dialysis. Cochrane Database Syst Rev 2022; 01: CD014653 DOI: 10.1002/14651858.CD014653.
• 53 Lin CH, Hsu YJ, Hsu PH. et al Effects of Intradialytic Exercise on Dialytic Parameters, Health-Related Quality of Life, and Depression Status in Hemodialysis Patients: A Randomized Controlled Trial. Int J Environ Res Public Health 2021; 18: 9205 DOI: 10.3390/ijerph18179205.
• 54 Goldberg AP, Hagberg JM, Delmez JA. et al Metabolic effects of exercise training in hemodialysis patients. Kidney Int 1980; 18: 754-761 DOI: 10.1038/ki.1980.194.
• 55 Hart A, Johansen KL. Cardiovascular protection and mounting evidence for the benefits of intradialytic exercise. Nephrol Dial Transplant 2019; 34: 1816-1818 DOI: 10.1093/ndt/gfz038.
• 56 Beddhu S, Baird BC, Zitterkoph J. et al Physical Activity and Mortality in Chronic Kidney Disease (NHANES III). CJASN 2009; 04: 1901-1906 DOI: 10.2215/CJN.01970309.
• 57 Bennett PN, Fraser S, Barnard R. et al Effects of an intradialytic resistance training programme on physical function: a prospective stepped-wedge randomized controlled trial. Nephrol Dial Transplant 2016; 31: 1302-1309 DOI: 10.1093/ndt/gfv416.
• 58 Karvonen J, Vuorimaa T. Heart rate and exercise intensity during sports activities. Practical application. Sports Med 1988; 05: 303-311 DOI: 10.2165/00007256-198805050-00002.
• 59 AOK PLUS. Im Internet. www.aok.de/pk/plus Stand: 31.03.2022
• 60 DiaTT – Dialyse Trainings-Therapie. Klinikum rechts der Isar der Technischen Universität München, Poliklinik für Präventive und Rehabilitative Sportmedizin. Im Internet. www.diatt.de Stand: 31.03.2022
• 61 von Gersdorff G, von Korn P, Duvinage A. et al Cluster Randomized Controlled Trial on the Effects of 12 Months of Combined Exercise Training during Hemodialysis in Patients with Chronic Kidney Disease-Study Protocol of the Dialysis Training Therapy (DiaTT) Trial. Methods Protoc 2021; 04: 60 DOI: 10.3390/mps4030060.