Limitações do estudo

São identificadas as seguintes limitações neste estudo:

A aferição do resultado da condição aeróbica através do treinamento cicloergométrico foi feito pelo teste de caminhada. Como há especificidade no treinamento, essa avaliação não específica (treino com bicicleta e avaliação com caminhada) pode ter subestimado os reais ganhos de performance aeróbica dos pacientes.

A função renal residual dos pacientes não foi aferida e isso pode ter influenciado o nível do BNP plasmático, dado o seu metabolismo renal.

O VO2 pico foi estimado pela fórmula de Cahalin et al. (1996) determinada para pacientes com IC, não tendo sido validada para pacientes com DRC, persistindo a necessidade de validação para essa população.

Apesar de o estudo aqui apresentado ser randomizado, não foi possível ocultar dos pesquisadores o conhecimento dos pacientes que fizeram parte do GE.

Como já comentado, o período de três meses pode ter sido muito curto para a detecção total ou mesmo parcial do impacto do EACI nos desfechos avaliados.

A perda de seguimento e as desistências foram além no número esperado e com isso houve redução da amostra, acima dos 18 pacientes calculados. O tamanho limitado da amostra não permitiu o controle de vários fatores que podem ter impactado no resultado como diabetes, tabagismo e medicações.

CONCLUSÕES

As principais conclusões deste estudo são:

1. Um programa de exercício aeróbico cicloergométrico intradialítico, com intensidade definida através do teste de caminhada de seis minutos, mostrou-se eficaz, seguro e prático em doentes renais crônicos em hemodiálise.

2. Os pacientes renais crônicos em hemodiálise que foram submetidos aos exercícios aeróbicos cicloergométricos intradialíticos apresentaram ganhos significativos na capacidade aeróbica (VO2 estimado e distância percorrida em seis minutos).

3. Houve redução estatisticamente significativa dos níveis de BNP nos pacientes que se submeteram ao protocolo de exercícios.

4. Não foram observadas reduções significativas em relação aos níveis da PCR em ambos os grupos estudados.

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