Chronic kidney disease (CKD) consists of kidney damage, with a consequent progressive and irreversible loss of kidney function. In the early stages of the disease, there is already a reduction in circulating levels of α-klotho protein, which is related to worsening renal function. Therapeutic strategies that increase serum α-klotho levels can be of great value in the treatment of CKD. Electrical stimulation contributes to the reduction of reactive oxygen species, DNA damage and improves the efficiency rate of dialysis, suggesting a systemic effect in patients with end-stage CKD. The aim of this study is to evaluate the effects of bioelectric stimulation on renal function and physical capacity in patients with CKD. For this, patients will be randomized into bioelectric stimulation or a control group. Bioelectric stimulation will be performed three times a week for eight weeks. The control group will only be evaluated and re-evaluated. The following pre-and post-intervention assessments will be performed: analysis of the plasma content of α-Klotho and soluble creatinine to assess renal function, six-minute walk test to assess functional capacity; dosage of interleukins and tumor necrosis factor to analyze the inflammatory profile; sit and stand test with 10 repetitions and load cell dynamometry to assess lower limb muscle strength and application of the EuroQoL-5D questionnaire for quality of life. Biochemical analyzes for renal function and inflammatory profile will also be performed after four weeks of follow-up.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
30
The sessions will include 20 minutes for stimulation of the thigh muscles and 45 minutes for stimulation of the kidneys. The electrodes will be placed on the motor point of the quadriceps muscle in both lower limbs. The neuromuscular electric stimulation will be applied by symmetrical biphasic pulsed current, at an 80 Hz frequency, 400 ms pulse width, 10 s contraction time, rest time decreasing as the protocol advanced, at reciprocal mode. The intensity will be individually adjusted to produce visible muscle contraction. Concomitant, two electrodes will be placed in the abdominal corresponding to the kidney anatomical site and two electrodes on the dorsal region at the level of the 10th thoracic vertebra. The stimulation of the kidneys will include in addition to Klotho, precise signals for several pro-regenerative proteins. The intensity of the electric current will be individually adjusted to sensory stimulation.
Change from kidney function
The kidney function will be assessed through the blood collection and dosage of serum creatinine
Time frame: Baseline, after 4 weeks and after 8 weeks
Change from kidney function
The kidney function will be assessed through the blood collection and dosage of α-klotho protein expression
Time frame: Baseline, after 4 weeks and after 8 weeks
Change from kidney function
The kidney function will be assessed through the glomerular filtration rate
Time frame: Baseline, after 4 weeks and after 8 weeks
Change in functional capacity
Functional capacity will be assessed by change in distance covered in the six minute walk test
Time frame: Baseline and after 8 weeks
Change in muscle strength
Muscle strength will be evaluated by dynamometry by a load cell
Time frame: Baseline and after 8 weeks
Change in muscle strength of the lower limbs
Muscle strength of the lower limbs will be assessed by sit-and-stand test of 10 repetitions
Time frame: Baseline and after 8 weeks
Change in quality of life evaluation
The quality of life will be assessed by questionnaire EuroQol-5D health questionnaire
Time frame: Baseline and after 8 weeks
Adverse effects
Adverse effects will be recorded in number of cases and type of event
Time frame: After 8 weeks
Change in inflammatory profile
The inflammatory profile will be assessed through the blood collection and analysis of immunological marker interleukin 6
Time frame: Baseline, after 4 weeks and after 8 weeks
Change in inflammatory profile
The inflammatory profile will be assessed through the blood collection and analysis of immunological marker interleukin 10
Time frame: Baseline, after 4 weeks and after 8 weeks
Change in inflammatory profile
The inflammatory profile will be assessed through the blood collection and analysis of immunological marker tumor necrosis factor
Time frame: Baseline, after 4 weeks and after 8 weeks
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