Determining factors of functioning in hemodialysis patients using the international classification of functioning, disability and health

使用国际功能、残疾和健康分类确定血液透析患者的功能因素

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作者:Luciana M M Santos, Pedro Henrique S Figueiredo, Ana C R Silva, Patrícia C Campos, Gabriele T Gonçalves, Jaqueline de Paula C Freitas, Fidelis Antônio da Silva Junior, Jousielle Márcia Santos, Frederico L Alves, Vanessa G B Rodrigues, Emílio Henrique B Maciel, Maria Cecília S M Prates, Borja Sañudo,

Background

Hemodialysis (HD) treatment affects functioning, physical activity level, clinical biomarkers, and body composition. However, the association between these variables with functioning, considering International Classification of Functioning, Disability and Health (ICF) domains remains unclear. Thus, the

Conclusion

Physical activity and PTH levels are determinant protagonists of functioning in all ICF domains in hemodialysis patients.

Methods

Eighty HD patients performed different tests grouped according to ICF domain: Body structure and function - handgrip strength (HS), 5-repetition sit-to-stand test, and 60-s sit-to-stand test (5-STS, 60-STS, respectively); Activity - short physical performance battery (SPPB); and Participation - participation scale questionnaire. Physical activity [Human Activity Profile questionnaire (HAP)], body composition (Dual-energy X-ray absorptiometry), Parathormone (PTH), and alkaline phosphatase were analyzed as possible variables associated with ICF domains. Data analyses were performed using simple and multiple regression models adjusted for age, duration of HD, and diuresis volume.

Results

In the body structure and function domain, appendicular lean mass, PTH level, and age were associated with HS (R2 = 0.558); HAP and PTH were associated with 5-STS (R2 = 0.263); and HAP, PTH, duration of HD, and age were associated with 60-STS (R2 = 0.337). In the activity domain, HAP, PTH, alkaline phosphatase, duration of HD, age, and body fat were associated with SPPB (R2 = 0.689). Finally, only HAP was associated with the participation scale (R2 = 0.067).

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