O efeito da auriculoterapia e exercício físico resistido no risco cardiovascular e sistema purinérgico em plaquetas de pacientes renais crônicos submetidos a hemodiálise

Abstract

Chronic Kidney Disease is characterized by progressive kidney damage and/or loss of function, requiring the implementation of therapies to maintain the body, given its dysregulation due to loss of renal function. Furthermore, patients with chronic kidney disease have a persistent risk of cardiovascular complications. Thus, the objective of this study is to evaluate the impact of resistance exercise and auriculotherapy techniques, as complementary and non- pharmacological practices, in patients diagnosed with chronic kidney disease undergoing hemodialysis, on the parameters of the purinergic system in platelets and cardiovascular risk. The study included 32 patients who underwent auriculotherapy, 29 who performed resistance exercise and 32 who performed both protocols concomitantly. The protocols lasted 12 weeks. Biological material (blood) was collected before the start of the protocols and one week after their completion. Routine exams were evaluated based on data from medical records. The parameters of routine biochemical tests before and after the intervention were analyzed, as well as the activity in platelets of the hydrolysis chain of ATP, ADP and AMP. For the statistical analyses, the GraphPad Prism 9.0 software was used, where, as it is non-parametric data, they were evaluated by the Kruskal-Wallis test, the results were presented as mean and standard error of the mean. Regarding the biochemical tests, an increase in the glomerular filtration rate was identified after the intervention in the resistance exercise group (p = 0.0451), and a reduction in sodium levels in the auriculotherapy (p = 0.0040), resistance exercise = 0.0018) and auriculotherapy + resistance exercise (p = <0.0001) groups. Under the parameters of the purinergic system, a reduction in the hydrolysis of ATP (p = 0.0005), ADP (p <0.0001) and AMP (p = 0.0008) was identified in the auriculotherapy group. The auriculotherapy + resistance exercise group showed a reduction in AMP hydrolysis after the intervention (p = 0.0076). No significant data were found in any of the groups studied under the ADA parameters. Thus, the adoption of complementary therapies, such as auriculotherapy and resistance exercise, for patients with CKD helps to improve health parameters, reduces cardiovascular risk and slows the progression of kidney disease. The application of longer-lasting protocols can promote biochemical and purinergic effects. However, there is a lack of studies on the isolated or combined use of these therapies in CKD and other chronic diseases.