7 In a moderate phase, there is loss of functional autonomy, and in more severe situations, there are fractures, which may even be fatal. The loss of balance, along with impaired mobility is a predisposing factor to the risk of falls, which in turn can cause from minor injuries to limitations in everyday life, 6 such as, going up and down stairs due to impairment of the locomotor and neurological system. 4 Thus, physical limitations tend to progress with patient’s advancing age, reducing flexibility, agility, mobility in joints and balance, which is the ability to remain erect and firm when inert or wandering. Moreover, physical activity, in general, decreases in patients having dialysis, and reduced activity or sedentary lifestyle is associated with lower levels of serum albumin and creatinine that show protein energy loss and small skeletal muscle mass. The more advanced the stage of the disease is, the greater the functional impairment presented by the patient due to the presence of sarcopenia is. 1, 3 The loss of muscle mass, strength reduction and muscle function is a serious indicator in kidney disease, as it characterizes the sarcopenia state, which along with uremia determines a progressive condition in renal disease. It is believed that besides the mechanisms mentioned, other factors that contribute to exercise performance may be related to electrolytic disturbance, metabolic acidosis, loss of muscle mass and atrophy of muscle fibers. The results showed reduced exercise performance in stages three and four of CKD, even in the absence of anemia and, exercise performance decreased progressively as renal function deteriorated. Only nine patients completed the two-year segment of the study. 1 A cohort study, performed with chronic renal patients in stage three and four, with no previous account of anemia, evaluated the relationships of aerobic exercise performance, muscle strength and fatigue with renal function and muscle mass, by using ergometric tests and leg strength tests, Cycle Ergometer and Oxygen Peak Consumption. Among them are hormonal imbalance, impaired nutrition and inadequate transport of O 2, in consequence of anemia. Symptoms of weakness and fatigue are commonly reported by patients, as a result of various mechanisms contributing to this process. Keywords: renal insufficiency, chronic, mobility limitation, nursing diagnosis AbbreviationsĬhronic kidney disease along with hemodialysis treatment alters people's lifestyles. Thus, it is crucial to reflect the real state of the patient to early pursue an accurate Nursing Diagnosis that best reflects the patient´s needs. The nursing diagnosis “Impaired physical mobility” suggests changes in gait running, which causes the increased risk for falls and dependence related to everyday activities. Impaired mobility in a functional perspective is seen as the inability of the individual to move freely. Also, with increasing age, physical limitations of chronic kidney patients on hemodialysis tend to progress, reducing flexibility, agility, mobility in joints and balance. The last one results in the reduction of mass, strength and muscle functioning. Symptoms such as weakness and fatigue are common in the population of chronic kidney patients, in consequence of a combination of multiple factors, including hormonal imbalance, impaired nutrition and inadequate transport of O 2, as a consequence of anemia, uremia, and sarcopenia.
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